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General NPI Number Information
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NPI Number | 1841151883
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE MEDICAL CARE WM
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Dates
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Enumeration Date | 11/19/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 4672 MAVERICK LN STE 1A
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City | LAKESIDE
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State | AZ
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Zip | 85929-5434
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Country | US
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Telephone | 520-404-9023
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Fax |
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Provider Business Mailing Address
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Address Line | 8969 TOMAHAWK TRL
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City | SHOW LOW
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State | AZ
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Zip | 85901-6878
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Country | US
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Telephone | 520-404-9023
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. YURI TALALAEV
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Credential | MD
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Telephone | 520-404-9023
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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 |
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License Number State |
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