Individual
ELOISA VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3690 S PARK AVE, SUITE 805, TUCSON, AZ 85713-5069
(520) 616-6760
(520) 616-6799
Mailing address
PO BOX 188, MARANA, AZ 85653-0188
(520) 682-4111
(520) 818-3630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22431
AZ
207Q00000X
Family Medicine Physician
G35890
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119602
MEDICARE PTAN
AZ
05
—
296709
—
AZ
Enumeration date
08/25/2006
Last updated
07/20/2015
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