Provider Demographics
NPI:1073954459
Name:ATONDO, DAVID J (FNP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:ATONDO
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W 24TH ST STE 26
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8372
Mailing Address - Country:US
Mailing Address - Phone:928-318-6910
Mailing Address - Fax:928-328-1056
Practice Address - Street 1:1025 W 24TH ST STE 26
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8372
Practice Address - Country:US
Practice Address - Phone:928-318-6910
Practice Address - Fax:928-328-1056
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP5040363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1962507376OtherFACILITY'S NPI
AZ1043324932OtherFACILITY'S NPI
1245344316OtherFACILITY'S NPI
1063433720OtherFACILITY'S NPI
AZ831027Medicaid
AZ1962507376OtherFACILITY'S NPI
1245344316OtherFACILITY'S NPI
1063433720OtherFACILITY'S NPI
AZ1043324932OtherFACILITY'S NPI