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General NPI Number Information
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NPI Number | 1043175896
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Entity Type | Organization
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Legal Business Name | YUMA REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 12/23/2025
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 845 E B ST
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City | SAN LUIS
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State | AZ
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Zip | 85336-3640
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Country | US
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Telephone | 928-336-2055
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Fax | 928-627-2456
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Provider Business Mailing Address
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Address Line | 845 E B ST
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City | SAN LUIS
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State | AZ
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Zip | 85336-3640
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Country | US
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Telephone | 928-336-2055
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Fax | 928-627-2456
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Authorized Official
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Title or Position | SVP & CFO
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Name | VERNON HATLEY MOORE III
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Credential |
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Telephone | 928-336-7015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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