MEDICARE: COMPREHENSIVE MEDICAL CARE WM LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1841151883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE MEDICAL CARE WM LLC

Provider Business Mailing Address
First Line	:	650 N PENROD RD STE A
Second Line	:
City	:	SHOW LOW
State	:	AZ
Zip	:	85901-5284
Country	:	US
Telephone Number	:	928-288-0123
Fax Number	:	877-682-6132

Provider Business Practice Location Address
First Line	:	4672 MAVERICK LN STE 1A
Second Line	:
City	:	LAKESIDE
State	:	AZ
Zip	:	85929-5434
Country	:	US
Telephone Number	:	520-404-9023
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. YURI TALALAEV
Credential	:	MD
Telephone Number	:	520-404-9023

Provider Enumeration Date	:	11/19/2025
Last Update Date	:	06/01/2026

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