Healthcare Provider Details

I. General information

NPI: 1306285432
Provider Name (Legal Business Name): DR. ABHINAV OHRI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 03/05/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 SANTA ROSA DR FL 3
KINGMAN AZ
86401-2311
US

IV. Provider business mailing address

3269 N STOCKTON HILL RD
KINGMAN AZ
86409-3619
US

V. Phone/Fax

Practice location:
  • Phone: 928-681-8745
  • Fax: 928-681-8744
Mailing address:
  • Phone: 928-263-4722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number57453
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: