Organization Name: | COMPREHENSIVE MEDICAL CARE PC |
NPI Number: | 1265523765 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | YURI TALALAEV (PRESIDENT) |
Mailing Address: | 17450 S La Canada Dr Sahuarita |
State: | AZ US |
Postal Code: | 856299718 |
Phone Number: | 5203930898 |
Fax Number: | 5203931750 |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 03/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 28484 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |