Individual provider Active NPI

Andres Zavala

  • Internal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1073826244
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R1816 Issued in AZ
Practice address
350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone
(602) 406-8798
Fax
(602) 294-5033
NPI assigned
Jul 16, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R1816 AZ Primary

Addresses

Primary practice location

350 W Thomas Rd
Phoenix, AZ 85013-4409

Mailing address

350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone (602) 406-8798

Other identifiers 1

IdentifierTypeStateIssuer
R1816OtherAZTRAINING PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R1816AZMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1073826244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-406-8798",
            "fax_number": "602-294-5033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-406-8798",
            "fax_number": "602-294-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVALA",
        "first_name": "ANDRES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-16",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R1816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING PERMIT",
            "identifier": "R1816",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; 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.