Provider Demographics
NPI:1639040173
Name:ASONGTIA, FOLEFAC
Entity type:Individual
Prefix:
First Name:FOLEFAC
Middle Name:
Last Name:ASONGTIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12568 E CADEN DR
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-1050
Mailing Address - Country:US
Mailing Address - Phone:520-440-8641
Mailing Address - Fax:
Practice Address - Street 1:12568 E CADEN DR
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-1050
Practice Address - Country:US
Practice Address - Phone:520-440-8641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program