Provider Demographics
NPI:1316248206
Name:MORALES, DAVID CARLOS (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CARLOS
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12450 N RANCHO VISTOSO BLVD
Mailing Address - Street 2:110
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-9548
Mailing Address - Country:US
Mailing Address - Phone:520-229-2080
Mailing Address - Fax:520-229-2092
Practice Address - Street 1:14300 W GRANITE VALLEY DR STE A1
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-5797
Practice Address - Country:US
Practice Address - Phone:623-777-4747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-08
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR710322084N0400X
AZ46572208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ926865Medicaid