Organization · NPI-2

Desert Spurs Primary Care, PLLC

Family Medicine · Bullhead City, AZ

NPI number1730634965
StatusActive
Last updated in NPPESAug 17, 2016

Details

NPI
1730634965
Entity type
Organization (NPI-2)
Legal business name
Desert Spurs Primary Care, PLLC
Organization subpart
No
Enumeration date
Aug 17, 2016
Last updated
Aug 17, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine48283AZYes

Practice location

1355 Ramar Rd
Ste. 10
Bullhead City, AZ 86442-7100

Phone 928-444-8405 · Fax 928-299-5300

Mailing address

251 Moser Ave
Apt. 105
Bullhead City, AZ 86429-5240

Phone 210-464-8311

Authorized official

Robert J Bazaco
Owner
2104648311

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