Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 34452 | AZ |
NPI | 1073588547 |
---|---|
Provider Name | Vicki Kalen |
First Address | Tucson, AZ 85716-5406 |
Second Address | Tucson, AZ 85716-5406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2006 |
Last Update Date | 13/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033307715 | GROUP NPI (01) | AZ |
1033398201 | GROUP NPI (01) | AZ |
1376731851 | GROUP NPI (01) | AZ |
1396933974 | GROUP NPI (01) | AZ |
1447448923 | GROUP NPI (01) | AZ |
1457543324 | GROUP NPI (01) | AZ |
1588843734 | GROUP NPI (01) | AZ |
1740479518 | GROUP NPI (01) | AZ |
1750579439 | GROUP NPI (01) | AZ |
1770771255 | GROUP NPI (01) | AZ |
1780873307 | GROUP NPI (01) | AZ |
1831387315 | GROUP NPI (01) | AZ |
1871782490 | GROUP NPI (01) | AZ |
A50420 | (02) | AZ |
Z120952 | GROUP PTAN (01) | |
Z126048 | GROUP PTAN (01) | AZ |
Z126262 | (02) | AZ |
Z126262 | MEDICARE PTAN (01) | AZ |
Z126263 | (02) | AZ |
Z126263 | MEDICARE PTAN (01) | AZ |