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MOHAVE NEPHROLOGYPC NPI 1669798823


NPI Information

NPI: 1669798823
Provider Name: MOHAVE NEPHROLOGY,PC
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 03D2143433

Address:
3535 E ANDY DEVINE AVE
KINGMAN, AZ
ZIP 86401
Phone: (928) 757-2050
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MOHAVE NEPHROLOGY,PC is a nephrology internal medicine in Kingman, AZ. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. MOHAVE NEPHROLOGY,PC NPI is 1669798823. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3535 E ANDY DEVINE AVE
KINGMAN, AZ
ZIP 86401-412
Phone: (928) 757-2050
Fax: (928) 757-2020

The provider's authorized official is Vijayavel Palanichamy .
The authorized official title is Pres and has the following contact phone number (928) 757-2050.

The CLIA number assigned to this NPI record is 03D2143433 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/13/2010 and was last updated on 2/4/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RN0300XInternal MedicineNephrology27022ARIZONAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G44078MEDICARE UPINARIZONA
2442682-02MEDICAIDARIZONA
329876MEDICARE PINARIZONA

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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