Provider Demographics
NPI:1679565519
Name:CIFUENTES, AURELIANO E (MD)
Entity Type:Individual
Prefix:DR
First Name:AURELIANO
Middle Name:E
Last Name:CIFUENTES
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 1:2727 W. BASELINE RD.
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283
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:2005-08-17
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ11483207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0400655OtherUHC PROVIDER ID
AZ2154623OtherAETNA PROVIDER ID
AZ418039Medicaid
AZ98014-189OtherGREAT WEST PROVIDER ID
AZAZ0714680OtherBC/BS PROVIDER ID
AZ750125OtherHUMANA
AZ99545OtherPACIFICARE
AZIZ8080OtherHEALTHNET
AZ6569834003OtherCIGNA
AZ98014-189OtherGREAT WEST PROVIDER ID
AZZ70005Medicare ID - Type UnspecifiedGROUP ID DR. CIFUENTES
AZ2154623OtherAETNA PROVIDER ID