EAST TUCSON IM & GERIATRICS INC NPI 1619968419

NPI Information

NPI: 1619968419
Provider Name: EAST TUCSON IM & GERIATRICS, INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 03D1085555

Address:
6556 E CARONDELET DR
TUCSON, AZ
ZIP 85710
Phone: (520) 296-8733
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EAST TUCSON IM & GERIATRICS, INC is a primary care clinic center in Tucson, AZ. EAST TUCSON IM & GERIATRICS, INC NPI is 1619968419. The provider is registered as an organization entity type.

The provider's business location address is:

6556 E CARONDELET DR
TUCSON, AZ
ZIP 85710-117
Phone: (520) 296-8733
Fax: (520) 296-8734

The provider's authorized official is Ramakrishnan Subbureddiar .
The authorized official title is President and has the following contact phone number (520) 296-8733.

The CLIA number assigned to this NPI record is 03D1085555 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2005 and was last updated on 11/29/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	30466	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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