Individual
DR. SENECA AKASHA CARRILLO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5102 W CAMPBELL AVE, MARYVALE HOSPITAL, PHOENIX, AZ 85031
(623) 848-5000
Mailing address
1740 E PURDUE AVE, PHOENIX, AZ 85020
(602) 405-0801
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
31008
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3981220
EVERCARE GRP
AZ
05
—
783721
—
AZ
01
—
AW1436
HEALTHNET GRP
AZ
01
—
AZ0728670
BLUE CROSS BLUE SHIELD GR
AZ
Enumeration date
05/02/2006
Last updated
07/08/2007
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