Provider Demographics
NPI:1316045750
Name:ONATE, LARRY G (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:G
Last Name:ONATE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2502 N DODGE BLVD
Mailing Address - Street 2:STE. 190
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2671
Mailing Address - Country:US
Mailing Address - Phone:520-618-8638
Mailing Address - Fax:520-617-1608
Practice Address - Street 1:2502 N DODGE BLVD
Practice Address - Street 2:STE. 190
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-2671
Practice Address - Country:US
Practice Address - Phone:520-618-8638
Practice Address - Fax:520-617-1608
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
AZ198732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ158677OtherAHCCCS