Healthcare Provider Details

I. General information

NPI: 1770629818
Provider Name (Legal Business Name): LA PAZ FAMILY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 W. ST. MARYS RD #125
TUCSON AZ
85745
US

IV. Provider business mailing address

4945 S. JOSEPH AVE
TUCSON AZ
85757
US

V. Phone/Fax

Practice location:
  • Phone: 520-884-4771
  • Fax: 520-884-4874
Mailing address:
  • Phone: 520-884-4771
  • Fax: 520-884-4874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN026569
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN026569
License Number StateAZ

VIII. Authorized Official

Name: DELMA B HUGGINS
Title or Position: PROVIDER/OWNER
Credential:
Phone: 520-884-4771