Doctor Name: | BART TRUJILLO |
NPI Number: | 1023365665 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RT(R) |
License Number: | 423717 |
Business Practice Address: | 12033 Agency Rd Parker, AZ - 853447718 |
Business Phone Number: | 9286693380 |
Business Fax Number: | |
Mailing Address: | 12033 Agency Rd, PARKER |
State: | AZ |
Postal Code: | 853447718 |
Phone Number: | 9286693380 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2012 |
NPI Last Update Date: | 08/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2471C3402X |
License Number: | 423717 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | Radiography |
Taxonomy Definition: |