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Individual

EMILIA ELIZABETH GOMEZ VIEYTEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
22707 S. ELLSWORTH RD H 101, QUEEN CREEK, AZ 85143
(480) 792-9200
(480) 792-9206
Mailing address
22707 S. ELLSWORTH RD H 101, QUEEN CREEK, AZ 85143
(480) 792-9200
(480) 792-9206

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
43623
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
43623
AZ MEDICAL BOARD LICENSE
AZ
01
80764
TRAINING PERMIT
AZ
Enumeration date
12/17/2007
Last updated
12/30/2015
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