Old Pueblo Dermatology LTD

Primary specialty

SpecialistTaxonomy code 174400000X

License

9882 Issued in AZ

Legal business name

OLD PUEBLO DERMATOLOGY LTD

Practice address

1980 W Hospital Dr
#307
Tucson, AZ 85704-7802

Phone

(520) 742-7777

Fax

(520) 742-9316

NPI assigned

Mar 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Joseph David Sosnow, MDNPI 1457419921

Title

President

Phone

(520) 742-7777

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph D Sosnow, MD

  • Dermatology Physician
  • Tucson, AZ
  • NPI 1457419921
  NPD (past) Authorized official
• Elena M Llivina, MD

  • Dermatology Physician
  • Birmingham, AL
  • NPI 1144389586
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003934977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 W HOSPITAL DR",
            "address_2": "#307",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047802",
            "telephone_number": "520-742-7777",
            "fax_number": "520-742-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 W HOSPITAL DR",
            "address_2": "#307",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047802",
            "telephone_number": "520-742-7777",
            "fax_number": "520-742-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD PUEBLO DERMATOLOGY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOSNOW",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "520-742-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "9882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Old Pueblo Cardiology PC
• Old Pueblo Children's Academy
• Old Pueblo Community Services
• Old Pueblo Community Services
• Old Pueblo Counseling, Incorporated
• Old Pueblo Healthcare LLC (Optima Medical)
• Old Pueblo Medical Tranportation, Inc. (Old Pueblo EMS)
• Old Pueblo Mobile Medicine LLC
• Old Pueblo Pediatrics
• Old Pueblo Plastic Surgery, P.C.

• Specialist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.