Durazo, Gustavo
Durazo, Gustavo is an individual health care provider with primary practice located at 1100 N F Ave , Douglas AZ 85607-1919. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as his primary health care specialty. Durazo, Gustavo can be contacted via phone (520) 364-3285.Contact Information
Primary practice address
1100 N F Ave
Douglas AZ 85607-1919
Phone: (520) 364-3285
Fax: (520) 364-4261
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 229416 | Arizona |
Profile Details
| NPI number | 1427600782 |
|---|---|
| LBN Legal business name | Durazo, Gustavo |
| Credentials | DNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 16th, 2019 |
| Last updated | Nov 15th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427600782 | NPPES |
| Arizona | MEDICAID | 583256 |
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