Healthcare Provider Details

I. General information

NPI: 1568658151
Provider Name (Legal Business Name): DESERT OASIS MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 S POINTE CIR STE 205
LAUGHLIN NV
89029-0423
US

IV. Provider business mailing address

3650 S POINTE CIR STE 205
LAUGHLIN NV
89029-0423
US

V. Phone/Fax

Practice location:
  • Phone: 928-758-0121
  • Fax: 928-758-0145
Mailing address:
  • Phone: 928-758-0121
  • Fax: 928-758-0145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number8165
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: WAHEED H ZEHRI
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 928-758-0121