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TRISTAN PICO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
725 S DOBSON RD, STE 100, CHANDLER, AZ 85224-5680
(602) 795-8700
(602) 795-8701
Mailing address
20280 N 59TH AVE, STE 115-617, GLENDALE, AZ 85308-6850
(602) 795-8700
(602) 795-8701

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
42864
AZ
207LP2900X
Pain Medicine (Anesthesiology) Physician
DR.0066661
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
514699
AZ
Enumeration date
05/03/2007
Last updated
06/09/2021
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