Provider Demographics
NPI:1932586484
Name:MANZO, RACHEL BAUMANN (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:BAUMANN
Last Name:MANZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:LAUREN
Other - Last Name:BAUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1501 N CAMPBELL AVE RM 3335
Mailing Address - Street 2:P.O. BOX 245073
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5073
Mailing Address - Country:US
Mailing Address - Phone:520-694-7432
Mailing Address - Fax:520-694-6688
Practice Address - Street 1:1501 N CAMPBELL AVE RM 3335
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-5073
Practice Address - Country:US
Practice Address - Phone:520-694-7432
Practice Address - Fax:520-694-6688
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR74948208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics