Basic Information
Provider Information
NPI: 1578903381
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAQUILAYAN
FirstName: YVETTE
MiddleName: J.
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3030 N CENTRAL AVE STE 1001
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850122716
CountryCode: US
TelephoneNumber: 6024064786
FaxNumber: 9166364358
Practice Location
Address1: 350 W THOMAS RD
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850134409
CountryCode: US
TelephoneNumber: 6024065590
FaxNumber: 6024167170
Other Information
ProviderEnumerationDate: 06/26/2013
LastUpdateDate: 03/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X006976AZN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XR22992AZN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X006976AZY Allopathic & Osteopathic PhysiciansHospitalist 

ID Information
IDTypeStateIssuerDescription
R2299201AZTRAINING PERMITOTHER


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