Individual
ANGELES OLIVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 E. CESAR CHAVEZ BLVD, SAN LUIS, AZ 85349
(928) 627-3822
(928) 627-3989
Mailing address
3071 S BRAND LEE WAY, YUMA, AZ 85365-5109
(602) 832-4462
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147479
—
AZ
Enumeration date
10/25/2021
Last updated
02/28/2023
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