Basic Information
| Provider Information | |||||||||
| NPI: | 1952396400 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VARON | ||||||||
| FirstName: | NESTOR | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29729 N 69TH LN | ||||||||
| Address2: | |||||||||
| City: | PEORIA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853833185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6232172237 | ||||||||
| FaxNumber: | 8774228771 | ||||||||
| Practice Location | |||||||||
| Address1: | 7119 E SHEA BLVD | ||||||||
| Address2: | SUITE 109-365 | ||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852546107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806076825 | ||||||||
| FaxNumber: | 4806078133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2005 | ||||||||
| LastUpdateDate: | 09/19/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 32203 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | P00192433 | 01 | AZ | RAILROAD MEDICARE | OTHER | 2Z2121 | 01 | AZ | HEALTHNET | OTHER | AZ0756150 | 01 | AZ | BCBS | OTHER | 862723 | 05 | AZ | MEDICAID |