Otto, Mario

Otto, Mario is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016-7710. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology, which is considered as his primary health care specialty. Otto, Mario can be contacted via phone (602) 933-0920.

Contact Information

Primary practice address
1919 E Thomas Rd Phoenix AZ 85016-7710
Phone: (602) 933-0920
Fax: (602) 933-2492
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X 52752-20 Wisconsin
Allopathic & Osteopathic Physicians / Pediatric Hematology-Oncology 2080P0207X 63758 Arizona

Profile Details

NPI number 1306064654
LBN Legal business name Otto, Mario
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2007
Last updated Oct 12th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306064654 NPPES
Arizona MEDICAID 097026

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