Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 22381 | AZ |
NPI | 1487611158 |
---|---|
Provider Name | Reyes R Topete |
First Address | Phoenix, AZ 85048-8702 |
Second Address | Phoenix, AZ 85048-8702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 25/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
335720 | (05) | AZ |
F89904 | (02) | AZ |