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NORTHSIDE MEDICAL CLINIC WALK IN LLC NPI 1245226398


NPI Information

NPI: 1245226398
Provider Name: NORTHSIDE MEDICAL CLINIC WALK IN LLC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

Address:
1394 W 16TH ST
YUMA, AZ
ZIP 85364
Phone: (928) 539-0055
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NORTHSIDE MEDICAL CLINIC WALK IN LLC is an urgent care clinic center in Yuma, AZ. NORTHSIDE MEDICAL CLINIC WALK IN LLC NPI is 1245226398. The provider is registered as an organization entity type.

The provider's business location address is:

1394 W 16TH ST
YUMA, AZ
ZIP 85364-430
Phone: (928) 539-0055
Fax: (928) 539-0053

The provider's authorized official is Daniel R. Ortiz .
The authorized official title is Medical Director and has the following contact phone number (928) 539-0055.

The enumeration date for this NPI number is 9/23/2005 and was last updated on 4/20/2008.


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
1261QU0200XClinic/CenterUrgent CareOTC3723ARIZONAYes

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
1=========OTHERARIZONANORTHSIDE TAX ID
2P54928MEDICARE UPINARIZONA
3H05396MEDICARE UPINARIZONA
4102893MEDICARE ID-TYPE UNSPECIFIEDARIZONAORTIZ MEDICARE
5AZ102887MEDICARE ID-TYPE UNSPECIFIEDARIZONANORTHSIDE MEDICARE
6102892MEDICARE ID-TYPE UNSPECIFIEDARIZONAWALLSTROM MEDICARE

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: 5/5/2024
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