# CARONDELET MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659326585
- **Authorized official:** MS. CHRISTEN A CASTELLANO MBA (EXECUTIVE VICE PRESIDENT, CHIEF STR)
- **Authorized official phone:** (520) 872-7638

## Contact information

- **Practice address:** 2202 N. FORBES BLVD, TUCSON, AZ 85745-1412
- **Practice address phone:** (520) 872-7790
- **Practice address fax:** (520) 872-7929
- **Mailing address:** 2202 N. FORBES BLVD, TUCSON, AZ 85745-1412
- **Mailing address phone:** (520) 872-7790
- **Mailing address fax:** (520) 872-7929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | AZ | — |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | NULL | — |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207VG0400X | Gynecology Physician | — | NULL | — |
| 207VG0400X | Gynecology Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 213ES0131X | Foot Surgery Podiatrist | — | NULL | — |
| 213ES0131X | Foot Surgery Podiatrist | — | — | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 06/27/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 653298 | — | AZ |