Provider Demographics
NPI:1033102835
Name:DEGUZMAN, ARLENE V (MD)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:V
Last Name:DEGUZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:V
Other - Last Name:DEGUZMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9401 W THUNDERBIRD RD STE 155
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4238
Mailing Address - Country:US
Mailing Address - Phone:623-249-2100
Mailing Address - Fax:623-476-7305
Practice Address - Street 1:9401 W THUNDERBIRD RD STE 155
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4238
Practice Address - Country:US
Practice Address - Phone:623-249-2100
Practice Address - Fax:623-476-7305
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ080180806OtherMEDICARE RAILROAD
AZ578990Medicaid
AZ578990Medicaid
AZ69208Medicare PIN
Z124251Medicare PIN