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General NPI Number Information
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NPI Number | 1831370576
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE OF YUMA LLC
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Dates
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Enumeration Date | 11/23/2007
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 2285 S ELKS LN
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City | YUMA
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State | AZ
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Zip | 85364-6258
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Country | US
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Telephone | 928-329-4761
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Fax | 928-329-4448
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Provider Business Mailing Address
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Address Line | 2285 S ELKS LN
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City | YUMA
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State | AZ
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Zip | 85364-6258
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Country | US
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Telephone | 928-329-4761
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Fax | 928-329-6742
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Authorized Official
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Title or Position | OWNER
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Name | DR. RINELY R AGUIAR-OLSEN
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Credential | M.D.
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Telephone | 928-329-4761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 28377
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License Number State | AZ
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