Healthcare Provider Details

I. General information

NPI: 1083670475
Provider Name (Legal Business Name): ADRIA ELENE OTTOBONI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ADRIA OTTOBONI WINTER M.D.

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16260 S RANCHO SAHUARITA BLVD
SAHUARITA AZ
85629-0047
US

IV. Provider business mailing address

1700 MOUNT VERNON AVE ROOM 1241
BAKERSFIELD CA
93306-4018
US

V. Phone/Fax

Practice location:
  • Phone: 520-416-7100
  • Fax:
Mailing address:
  • Phone: 661-326-2220
  • Fax: 661-326-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA82458
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberA82458
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number75088
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: