Provider Demographics
NPI:1417543117
Name:CHING, CARLOS ALBERTO (FNP)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:ALBERTO
Last Name:CHING
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:MR
Other - First Name:CARLOS
Other - Middle Name:ALBERTO
Other - Last Name:CHING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CARLOS A CHING, FNP
Mailing Address - Street 1:1520 W SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85041-9137
Mailing Address - Country:US
Mailing Address - Phone:602-578-0627
Mailing Address - Fax:
Practice Address - Street 1:1520 W SUNRISE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-9137
Practice Address - Country:US
Practice Address - Phone:602-578-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ250847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty