Individual
MR. AUSTIN MATIAS BACONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9827 N 95TH ST STE 105, SCOTTSDALE, AZ 85258-4591
(480) 860-8488
Mailing address
9827 N 95TH ST STE 105, SCOTTSDALE, AZ 85258-4591
(480) 860-8488
(480) 860-8498
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7519
AZ
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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