ABAN CARE CLINIC LLC NPI 1649366378

NPI Information

  • NPI: 1649366378
  • Provider Name: ABAN CARE CLINIC LLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 03D1063473
  • Address: 2182 HIGHWAY 95
    BULLHEAD CITY, AZ
    ZIP 86442
  • Phone: (928) 758-6420

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NPI Details

ABAN CARE CLINIC LLC is a specialist in Bullhead City, AZ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ABAN CARE CLINIC LLC NPI is 1649366378. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2182 HIGHWAY 95
BULLHEAD CITY, AZ
ZIP 86442-044
Phone: (928) 758-6420
Fax: (928) 758-6509

The provider's authorized official is Guillermo G Zegarra .
The authorized official title is Member/physician and has the following contact phone number (928) 758-6420.

The CLIA number assigned to this NPI record is 03D1063473 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/4/2006 and was last updated on 7/24/2025.

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
1174400000XSpecialist32150ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12976OTHERARIZONABUSINESS LICENSE
2932401MEDICAIDARIZONA

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: 11/21/2025

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