Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Puerto Sonora Internal Medicine

Organization Addiction Medicine (Family Medicine) Physician · NPI 1427635408

Puerto Sonora Internal Medicine is an Addiction Medicine (Family Medicine) Physician in Tempe, Arizona. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
4
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Practice location Address checks out

4653 S Lakeshore Dr Ste 3
Tempe, AZ 85282-7161
Phone: (480) 456-8981
Fax: (480) 456-2906
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Addiction Medicine (Family Medicine) Physician Taxonomy 207QA0401X
Adult Medicine Physician Taxonomy 207QA0505X
Pain Medicine Physician Taxonomy 208VP0000X

Record details

NPI number1427635408
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lynn Pangallo — Accounting Manager - Credentialing · (702) 375-5777
NPI enumeratedMarch 25, 2021
Last updated in NPPESFebruary 28, 2023
Certification dateFebruary 28, 2023
Mailing address4653 S Lakeshore Dr Ste 3, Tempe, AZ 85282-7161

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