Provider Demographics
NPI:1598804510
Name:CIFUENTES, JR., ENRIQUE M (MD)
Entity Type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:M
Last Name:CIFUENTES, JR.
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2727 W BASELINE RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1068
Mailing Address - Country:US
Mailing Address - Phone:602-323-0904
Mailing Address - Fax:602-243-7616
Practice Address - Street 1:2727 W BASELINE RD
Practice Address - Street 2:SUITE 8
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1067
Practice Address - Country:US
Practice Address - Phone:602-323-0904
Practice Address - Fax:602-243-7616
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2014-12-05
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Provider Licenses
StateLicense IDTaxonomies
AZ42048207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine