Provider Demographics
NPI:1386649796
Name:CINTORA, ISMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ISMAR
Middle Name:
Last Name:CINTORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 N 3RD ST
Mailing Address - Street 2:STE 203
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1145
Mailing Address - Country:US
Mailing Address - Phone:602-279-4442
Mailing Address - Fax:602-279-5333
Practice Address - Street 1:2601 N 3RD ST
Practice Address - Street 2:STE 203
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1145
Practice Address - Country:US
Practice Address - Phone:602-279-4442
Practice Address - Fax:602-279-5333
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10195174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ42980OtherUNITED HEALTHCARE
AZ1Z2013OtherHEALTHNET
AZ4120200OtherCIGNA
AZ697062OtherAETNA
AZ0002315720OtherDES
AZAZ0071170OtherBCBS
AZ0002315720OtherDES
AZ42980OtherUNITED HEALTHCARE