Provider Demographics
NPI:1750583951
Name:LARA, RAY JONATHAN (DO)
Entity type:Individual
Prefix:DR
First Name:RAY
Middle Name:JONATHAN
Last Name:LARA
Suffix:
Gender:
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2506 E VISTOSO COMMERCE LOOP STE 180
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-9114
Mailing Address - Country:US
Mailing Address - Phone:520-775-3333
Mailing Address - Fax:520-775-3334
Practice Address - Street 1:2506 E VISTOSO COMMERCE LOOP STE 180
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-9114
Practice Address - Country:US
Practice Address - Phone:520-775-3333
Practice Address - Fax:520-775-3334
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ005067207YX0905X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery