Provider Demographics
NPI:1639145568
Name:TECSON, CHARINA F (MD)
Entity Type:Individual
Prefix:
First Name:CHARINA
Middle Name:F
Last Name:TECSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6242 E ARBOR AVE
Mailing Address - Street 2:SUITE 113
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-1309
Mailing Address - Country:US
Mailing Address - Phone:480-325-1123
Mailing Address - Fax:480-325-1124
Practice Address - Street 1:6242 E ARBOR AVE
Practice Address - Street 2:SUITE 113
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1309
Practice Address - Country:US
Practice Address - Phone:480-325-1123
Practice Address - Fax:480-325-1124
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32157207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ860694Medicaid
AZ860694Medicaid
AZZ82236Medicare PIN