Individual provider Active NPI

Alfonso Tadeus Zavala

  • Student in an Organized Health Care Education/Training Program
  • Tucson, AZ
National Provider Identifier
1134749872
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
D10537387 Issued in AZ
Practice address
1625 N Campbell Ave
Tucson, AZ 85719-4330
Phone
(520) 694-0111
NPI assigned
Apr 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X D10537387 AZ Primary

Addresses

Primary practice location

1625 N Campbell Ave
Tucson, AZ 85719-4330

Mailing address

1025 N Euclid Ave
Tucson, AZ 85719-4411
Phone (970) 764-5613

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL laptop Health Information Exchange (HIE)

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D10537387AZMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1134749872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 N EUCLID AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194411",
            "telephone_number": "970-764-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N CAMPBELL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194330",
            "telephone_number": "520-694-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVALA",
        "first_name": "ALFONSO",
        "middle_name": "TADEUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AZ",
            "license": "D10537387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1625 N Campbell Ave",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857194330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.