MEDICARE: SAGUARO DIRECT CARE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1598608259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAGUARO DIRECT CARE, PLLC

Provider Business Mailing Address
First Line	:	3741 KIOWA BLVD S
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86404-2334
Country	:	US
Telephone Number	:	928-813-3685
Fax Number	:	928-268-0240

Provider Business Practice Location Address
First Line	:	3741 KIOWA BLVD S
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86404-2334
Country	:	US
Telephone Number	:	928-813-3685
Fax Number	:	928-268-0240

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	ZANE AHMED
Credential	:	DO
Telephone Number	:	928-813-3685

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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