Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | DO2849 | AZ |
N | 207R00000X | Internist | DO2849 | AZ |
N | 111NI0900X | Internist | DO2849 | AZ |
NPI | 1366534893 |
---|---|
Provider Name | Dr. Victoria Troncoso |
First Address | Scottsdale, AZ 85258-4581 |
Second Address | Scottsdale, AZ 85258-4581 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 09/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F72680 | (02) | AZ |
Z76288 | PTAN (01) | AZ |