Individual
CHUCK STEPHEN MANGUBAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3115 S PRICE RD, CHANDLER, AZ 85248-3544
(480) 926-0170
(480) 452-0715
Mailing address
3115 S PRICE RD, CHANDLER, AZ 85248-3544
(480) 926-0170
(602) 765-9513
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24330
AZ
208M00000X
Hospitalist Physician
24330
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110237007
MEDICARE RAIL ROAD
AZ
05
—
36322604
—
AZ
Enumeration date
02/26/2006
Last updated
03/22/2016
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