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General NPI Number Information
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NPI Number | 1699765834
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Entity Type | Organization
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Legal Business Name | RIO VISTA SURGICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 90 RIVIERA DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5716
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Country | US
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Telephone | 928-453-2900
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Fax | 877-864-6566
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Provider Business Mailing Address
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Address Line | 90 RIVIERA DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5716
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Country | US
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Telephone | 928-453-2900
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Fax | 877-864-6566
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Authorized Official
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Title or Position | MD/OWNER
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Name | ABEDON ABE SAIZ JR.
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Credential | MD
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Telephone | 928-453-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 24387
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 24387
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License Number State | AZ
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