Provider Demographics
NPI:1679561203
Name:RODRIGUEZ-ASBUN, ARMANDO (MD)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:RODRIGUEZ-ASBUN
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 1:5620 W THUNDERBIRD RD STE B2
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4638
Mailing Address - Country:US
Mailing Address - Phone:623-215-9447
Mailing Address - Fax:
Practice Address - Street 1:250 W CHANDLER HEIGHTS RD BLDG 300
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-5055
Practice Address - Country:US
Practice Address - Phone:888-698-6727
Practice Address - Fax:602-560-2721
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24283207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FQ31810BKMedicare ID - Type Unspecified
G37287Medicare UPIN