Provider Demographics
NPI:1710131859
Name:TOMAZIN, JOHN E (PA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:TOMAZIN
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:1241 W MINERAL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5685
Mailing Address - Country:US
Mailing Address - Phone:303-759-0854
Mailing Address - Fax:303-759-0864
Practice Address - Street 1:350 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4409
Practice Address - Country:US
Practice Address - Phone:602-406-3000
Practice Address - Fax:602-406-7165
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2008-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ4183363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
COZ126169Medicare PIN