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NPI Code Detail

MEDICARE: CRITICAL CARE ASSOCIATES OF YUMA, LLC

MEDICARE: CRITICAL CARE ASSOCIATES OF YUMA, LLC
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
1207RP1001XPulmonary Disease Physician
2207RC0200XCritical Care Medicine (Internal Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609839562
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRITICAL CARE ASSOCIATES OF YUMA, LLC
Provider Business Mailing Address
First Line : 2450 S 4TH AVE
Second Line : STE 200
City : YUMA
State : AZ
Zip : 85364-8573
Country : US
Telephone Number : 928-317-9100
Fax Number :
Provider Business Practice Location Address
First Line : 2400 S AVE A
Second Line :
City : YUMA
State : AZ
Zip : 85364-7127
Country : US
Telephone Number : 928-344-2000
Fax Number :
Authorized Official
Title or Position : PARTNER
Name : DR. SRIDHAR RAJAMANI
Credential : MD
Telephone Number : 928-317-9100
Provider Enumeration Date : 04/10/2006
Last Update Date : 12/17/2007

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