Individual
JOSE ALBERTO AGOSTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 SOUTH EXTENSION ROAD, MESA, AZ 85210
(480) 834-2912
(480) 834-3536
Mailing address
310 SOUTH EXTENSION ROAD, MESA, AZ 85210
(480) 834-2912
(480) 834-3536
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
32694
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
881674
—
AZ
Enumeration date
10/23/2006
Last updated
12/15/2016
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