DR. OVICTOR LEO ROLDAN TESORO


Address: 2601 E Roosevelt St, Phoenix, AZ 85008-4973
Phone: 6023445011

DR. OVICTOR LEO ROLDAN TESORO (NPI# 1356584759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356584759
Entity Type Individual
Full Name DR. OVICTOR LEO ROLDAN TESORO
Credential M.D.
Practice Address 2601 E Roosevelt St
Phoenix
AZ 85008-4973
Mailing Address 4301 N 21st St
Phoenix
AZ 85016-5552
Practice Telephone 6023445011
Mailing Telephone 6023441691
Enumeration Date 2009-04-14
Last Update Date 2015-03-09
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2084N0402X Psychiatry & Neurology
Specialization: Neurology with Special Qualifications in Child Neurology
47955 AZ Allopathic & Osteopathic Physicians

Office Location

Street Address 2601 E ROOSEVELT ST
City PHOENIX
State AZ
Zip Code 85008-4973

Providers in the same location

NPI Name Taxonomy Address Enumeration
1538166152 Paul Zidel I Orthopaedic Surgery 2601 E Roosevelt St, Dept of Surgery, Phoenix, AZ 85008-4973 2005-06-29
1881293165 Christina Wellman Registered Nurse 2601 E Roosevelt St, Phoenix, AZ 85008-4973 2020-10-19
1639786544 Lindsey Tow Nurse Anesthetist, Certified Registered 2601 E Roosevelt St, Phoenix, AZ 85008-4973 2020-09-24
1003424102 Susannamma Lijan Nurse Practitioner 2601 E Roosevelt St, Phoenix, AZ 85008-4973 2020-07-15
1184241705 Katharine Witham Anesthesiology 2601 E Roosevelt St, Phoenix, AZ 85008-4973 2020-06-30
1417574435 Vishal Ravella Student in an Organized Health Care Education/Training Program 2601 E Roosevelt St, Valleywise Health, Phoenix, AZ 85008 2020-06-26
1841814894 Anthony Howard Arnett Nurse Anesthetist, Certified Registered 2601 E Roosevelt St, Phoenix, AZ 85008-4973 2020-06-05
1053932277 Bhavesh Shukla Student in an Organized Health Care Education/Training Program 2601 E Roosevelt St, Phoenix, AZ 85008-4973 2020-04-28
1659991016 Luis Francisco Meza Student in an Organized Health Care Education/Training Program 2601 E Roosevelt St, Phoenix, AZ 85008-4973 2020-04-25
1396365839 Nicholas Donahue Winter Student in an Organized Health Care Education/Training Program 2601 E Roosevelt St, Phoenix, AZ 85008-4973 2020-04-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1821607060 Am Apnea and Tmj LLC Durable Medical Equipment & Medical Supplies 2303 N. 44thst., Suite 14-1008, Phoenix, AZ 85008 2020-07-23
1194341131 Abdulbaril Olandapo Olagunju Student in an Organized Health Care Education/Training Program 2601 E Roosevelt Street, Valleywise Health, Phoenix, AZ 85008 2020-06-24
1376164632 Abdul Rahman Raed Mustafa Halawa Student in an Organized Health Care Education/Training Program 2601 E Roosevelt St Valleywise Health, Phoenix, AZ 85008 2020-04-28
1245869460 Zachary Masuda Student in an Organized Health Care Education/Training Program Valleywise Health Medical Center, 2601 E Roosevelt St, Phoenix, AZ 85008 2020-04-08
1942840145 Cana Behavior LLC Physical Therapist 2412 N 36 Pl, Phoenix, AZ 85008 2020-01-15
1871158188 Fred Gardezy Student in an Organized Health Care Education/Training Program Maricopa Integrated Health System 2601 E. Roosevelt St., Phoenix, AZ 85008 2019-05-02
1225692346 Navkaran Singh Girgla Student in an Organized Health Care Education/Training Program 2601 East Roosevelt St., Phoenix, AZ 85008 2019-04-24
1316412323 Southwest Human Developement Early Intervention Provider Agency 2850 N 24h Street, Phoenix, AZ 85008 2018-10-05
1558885970 Mona Ridhwan Ziems Midwife 1919 N 31st St, Phoenix, AZ 85008 2017-07-27
1093244451 Shana Cynamon Audiologist 1801 N 37th Pl, Phoenix, AZ 85008 2017-06-08
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Taxonomy Information

Taxonomy Code 2084N0402X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Neurology with Special Qualifications in Child Neurology

Taxonomy Definition

A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence.
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1801900584 Vinodh Narayanan Psychiatry & Neurology 3330 N 2nd St Ste 402, Phoenix, AZ 85012 2006-08-18
1871835918 Jennifer Ashley Heim Psychiatry & Neurology 1919 E Thomas Rd, Phoenix, AZ 85016-7710 2013-03-26
1982946299 Deepali D Eksambe Psychiatry & Neurology 2601 E Roosevelt St, Phoenix, AZ 85008-4973 2013-03-25
1881952794 Jordana Fox Kensicki Psychiatry & Neurology 1919 E Thomas Rd, Phoenix, AZ 85016-7710 2012-04-28
1770849275 Kavitha Tirumalasetti Karnik Psychiatry & Neurology 1919 E Thomas Rd, Phoenix, AZ 85016 2012-04-09
1518250224 Apnna - Arizona Pediatric Neurology & Neurogenetics Associates Psychiatry & Neurology 222 W Thomas Rd, Suite 406, Phoenix, AZ 85013-4419 2011-05-27
1396037644 Brian Leonard Appavu Psychiatry & Neurology 1919 E Thomas Rd, Phoenix, AZ 85016-7710 2011-05-04
1255569976 Beth Ann Haynes Psychiatry & Neurology 1919 E Thomas Rd, Ambulatory Building, Phoenix, AZ 85016-7710 2009-07-01
1922234392 Varina Louise Boerwinkle Psychiatry & Neurology 1919 E Thomas Rd, Phoenix, AZ 85016-7710 2009-05-29
1073797700 Reena Gogia Rastogi Psychiatry & Neurology 1919 E Thomas Rd, Phoenix, AZ 85016-7710 2007-12-17
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Competitor

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City PHOENIX
Zip Code 85008

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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