Provider Demographics
NPI:1881774131
Name:ZARRAGA, IRENE (MD)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:ZARRAGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IRENE CRISTIYA
Other - Middle Name:VEGA
Other - Last Name:ZARRAGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2555 E GILA RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-2240
Mailing Address - Country:US
Mailing Address - Phone:928-317-9972
Mailing Address - Fax:928-317-9789
Practice Address - Street 1:2555 E GILA RIDGE RD
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-2240
Practice Address - Country:US
Practice Address - Phone:928-317-9972
Practice Address - Fax:928-317-9789
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40930207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E68910Medicare UPIN
AZE68910Medicare UPIN