Tabanda-Lichauco, Rosa Trinidad C

Tabanda-Lichauco, Rosa Trinidad C is an individual health care provider with primary practice located at 300 El Camino Real , Sierra Vista AZ 85635-2812. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Tabanda-Lichauco, Rosa Trinidad C can be contacted via phone (520) 335-1800.

Contact Information

Primary practice address
300 El Camino Real Sierra Vista AZ 85635-2812
Fax: (520) 335-2743
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 36678 Arizona
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 36678 Arizona

Profile Details

NPI number 1922216233
LBN Legal business name Tabanda-Lichauco, Rosa Trinidad C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 18th, 2007
Last updated Aug 27th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922216233 NPPES
Arizona MEDICAID 824163

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