MEDICARE: VISTA HEALTH MIRZA MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QU0200X	Urgent Care Clinic/Center
2	207R00000X	Internal Medicine Physician
3	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1033393194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISTA HEALTH MIRZA MD PC

Provider Business Mailing Address
First Line	:	5653 S HIGHWAY 95
Second Line	:	STE A
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-6068
Country	:	US
Telephone Number	:	928-768-2558
Fax Number	:	928-758-4659

Provider Business Practice Location Address
First Line	:	5653 S HIGHWAY 95
Second Line	:	STE A
City	:	FORT MOHAVE
State	:	AZ
Zip	:	86426-6068
Country	:	US
Telephone Number	:	928-768-2558
Fax Number	:	928-768-2874

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. IRFAN M MIRZA
Credential	:	M.D.
Telephone Number	:	928-768-2558

Provider Enumeration Date	:	12/26/2007
Last Update Date	:	08/02/2024

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