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General NPI Number Information
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NPI Number | 1548483571
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Entity Type | Organization
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Legal Business Name | YUMA EAR, NOSE AND THROAT, LTD
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 2320 S 22ND DR
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City | YUMA
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State | AZ
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Zip | 85364-8867
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Country | US
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Telephone | 928-920-4772
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 349
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City | YUMA
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State | AZ
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Zip | 85366-2313
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Country | US
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Telephone | 928-920-4772
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID S KABA
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Credential | MD
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Telephone | 928-919-3510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | AZ
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