Individual
DEREK JONATHAN CARBAJAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3921 W BASELINE RD, LAVEEN, AZ 85339-1801
(602) 764-4000
Mailing address
6837 E FLOSSMOOR AVE, MESA, AZ 85208-2613
(602) 725-8721
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN205388
AZ
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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