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General NPI Number Information
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NPI Number | 1063503530
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Entity Type | Organization
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Legal Business Name | COUNTY OF YUMA
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 03/25/2013
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Provider Practice Location Address
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Address Line | 2200 W 28TH ST
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City | YUMA
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State | AZ
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Zip | 85364
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Country | US
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Telephone | 928-317-4550
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Fax | 928-317-4591
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Provider Business Mailing Address
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Address Line | 2200 W 28TH ST
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City | YUMA
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State | AZ
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Zip | 85364
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Country | US
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Telephone | 928-317-4550
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Fax | 928-317-4591
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. DIANA GOMEZ
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Credential |
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Telephone | 928-317-4550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OTC 0285
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License Number State | AZ
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