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SAN LUIS WALK-IN CLINIC INC. NPI 1770211781


NPI Information

NPI: 1770211781
Provider Name: SAN LUIS WALK-IN CLINIC, INC.

Doing Business As: LAKE HAVASU PEDIATRIC FAMILY CLINIC - MOBILE UNIT

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 03D1107277

Address:
1940 MESQUITE AVE
LAKE HAVASU CITY, AZ
ZIP 86403
Phone: (928) 459-3512
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SAN LUIS WALK-IN CLINIC, INC. is a clinic center in Lake Havasu City, AZ. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SAN LUIS WALK-IN CLINIC, INC. NPI is 1770211781. The provider is registered as an organization entity type.
The provider Is Doing Business As Lake Havasu Pediatric Family Clinic - Mobile Unit.

The provider's business location address is:

1940 MESQUITE AVE
LAKE HAVASU CITY, AZ
ZIP 86403-123
Phone: (928) 459-3512
Fax: (928) 459-3514

The provider's authorized official is Amanda Aguirre .
The authorized official title is President & Ceo and has the following contact phone number (928) 315-7910.

The CLIA number assigned to this NPI record is 03D1107277 - prison with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/9/2022 and was last updated on 9/7/2023.


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
1261QM1300XClinic/CenterMulti-SpecialtyNo
2261Q00000XClinic/CenterYes

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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