Healthcare Provider Details

I. General information

NPI: 1386559136
Provider Name (Legal Business Name): SAN LUIS WALK-IN CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 S OAK AVE STE 4
SAN LUIS AZ
85336-0756
US

IV. Provider business mailing address

PO BOX 617
SOMERTON AZ
85350-0617
US

V. Phone/Fax

Practice location:
  • Phone: 928-662-0406
  • Fax:
Mailing address:
  • Phone: 928-662-0406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMANDA AGUIRRE
Title or Position: PRESIDENT & CEO
Credential:
Phone: 928-315-7910