Individual
HUMBERTO ROBERT INZUNZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5116 S SALK LN, MESA, AZ 85212-8005
(661) 221-2552
Mailing address
5116 S SALK LN, MESA, AZ 85212-8005
(661) 221-2552
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
207Q00000X
Family Medicine Physician
6604
AZ
207QG0300X
Geriatric Medicine (Family Medicine) Physician
6604
AZ
2080A0000X
Pediatric Adolescent Medicine Physician
6604
AZ
251E00000X
Home Health Agency
6604
AZ
261QU0200X
Urgent Care Clinic/Center
6604
AZ
363A00000X
Physician Assistant
Primary
6604
AZ
363A00000X
Physician Assistant
PA21592
CA
363AS0400X
Surgical Physician Assistant
PA21592
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254343
—
AZ
Enumeration date
07/12/2011
Last updated
02/10/2020
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