Individual
CHRISTINE REGINA FUKUMOTO RUKASIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-0985
(602) 933-2423
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
57762
AZ
208000000X
Pediatrics Physician
57762
AZ
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
57762
AZ
Other
Enumeration date
05/26/2012
Last updated
06/12/2024
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