Provider Demographics
NPI:1689896094
Name:CHARINA TECSON MD PC
Entity Type:Organization
Organization Name:CHARINA TECSON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARINA
Authorized Official - Middle Name:F
Authorized Official - Last Name:TECSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-325-1123
Mailing Address - Street 1:6242 E ARBOR AVE
Mailing Address - Street 2:SUITE113
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:SUITE113
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ82234Medicare PIN