| Doctor Name: | JOSE IVAN RAGO |
| NPI Number: | 1477714137 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | R70138 |
| Business Practice Address: | 287 E. Hunt Highway Suite 105 San Tan Valley, AZ - 851435096 |
| Business Phone Number: | 4806778282 |
| Business Fax Number: | 4806778283 |
| Mailing Address: | 4600 S. Mill Avenue, Suite 280 TEMPE |
| State: | AZ |
| Postal Code: | 852826850 |
| Phone Number: | 4803052888 |
| Fax Number: | 4803052889 |
| NPI Enumeration Date: | 06/24/2008 |
| NPI Last Update Date: | 08/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | R70138 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |