Colton Health Az, LLC
Clinic/Center, Medical Specialty in Kingman, AZ. Organization (NPI-2).
NPI number1124635396
StatusActive
Last updated in NPPESApr 13, 2023
Details
- NPI
- 1124635396
- Entity type
- Organization (NPI-2)
- Legal business name
- Colton Health Az, LLC
- Organization subpart
- No
- Enumeration date
- Sep 30, 2020
- Certification date
- Apr 13, 2023
- Last updated
- Apr 13, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | – | – | Yes |
| 261QI0500X | Clinic/Center, Infusion Therapy | – | – |
Practice location
890 Airway AveKingman, AZ 86409-3588
Phone 928-681-1234 · Fax 928-681-1811
Mailing address
9457 E Adobe DrScottsdale, AZ 85255-5077
Phone 602-702-3955
Authorized official
Sukhjit Singh Ghuman
Group Chairman And Ceo
6027023955
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