Individual
JOSE RAMON SANCHEZ BASTIDAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
1453 N MAIN STREET, SUITE 6, SAN LUIS, AZ 85336
(928) 459-3508
(928) 459-3515
Mailing address
PO BOX 617, SOMERTON, AZ 85350-0617
(928) 315-7910
(928) 722-6113
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN180685
AZ
363LF0000X
Family Nurse Practitioner
Primary
271774
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121183
—
AZ
Enumeration date
02/24/2022
Last updated
03/18/2022
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