VEIN CLINIC OF LAKE HAVASU (NPI# 1285188763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285188763 |
| Entity Type | Organization |
| Organization Name | VEIN CLINIC OF LAKE HAVASU |
| Practice Address |
2156 Rudolph Dr Lake Havasu City AZ 86406-8106 |
| Practice Telephone | 9284531800 |
| Mailing Telephone | 9284531800 |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-10-19 |
| Authorized Official Name | BOBBY A SHAH (OWNER) |
| Authorized Official Telephone | 9284531800 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| Street Address |
2156 RUDOLPH DR |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86406-8106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497924070 | James Richard Fisher | Durable Medical Equipment & Medical Supplies | 2540 Viejo Dr, Lake Havasu City, AZ 86406 | 2008-02-27 |
| 1265657969 | Eugene Vitvitsky Md | Surgery | 2046 Burke Lane, Lake Havasu City, AZ 86406 | 2007-04-16 |
| 1659497105 | Assisted Living Concepts Inc | Assisted Living Facility | 3076 Shoshone Drive, Lake Havasu, AZ 86406 | 2007-03-22 |
| 1164546750 | Charles Reese Mead | Dentist | 101 Riveria Dr, Lake Havasu, AZ 86406 | 2007-03-19 |
| 1427172550 | Jesdeen Lynn Nunez | Registered Nurse | 12033 Agency Road, Parker, AZ 86406 | 2007-03-16 |
| 1285797993 | Karen Ann Powell | Podiatrist | Oro Grande Elementary 1250 Pawnee Drive, Lake Havasu City, AZ 86406 | 2006-12-18 |
| 1215978606 | Founders Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2800 Sweetwater Ave, Lake Havasu City, AZ 86406 | 2006-06-09 |
| 1467519512 | Catherine Evelyn Sondrol | Occupational Therapist | 3588 Tarpon Dr, Lake Havasu City, AZ 86406-4223 | 2007-01-01 |
| 1346477593 | Steven Bertovich | Registered Nurse | 3499 Tarpon Dr, Lake Havasu City, AZ 86406-4246 | 2009-06-15 |
| 1093975310 | Serenity Assisted Living | Assisted Living Facility | 3677 Blue Colt Dr, Lake Havasu City, AZ 86406-4273 | 2008-06-10 |
| Find all providers in zip 86406 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144704610 | Imaging Advanced Consultants LLC | Clinic/Center | 4566 E Inverness Ave Ste 102, Mesa, AZ 85206-4633 | 2018-09-20 |
| 1124552120 | Smi Imaging, LLC | Clinic/Center | 2502 E Camelback Rd, 160, Phoenix, AZ 85016-4254 | 2017-04-17 |
| 1184165938 | Az Med LLC | Clinic/Center | 706 N Mcqueen Rd, Gilbert, AZ 85233-3500 | 2017-03-13 |
| 1841537842 | Az-tech Radiology & Open Mri, LLC | Clinic/Center | 600 S. Dobson Rd Suite, Suite E42, Chandler, AZ 85224-0000 | 2013-01-10 |
| 1881939874 | Extremity Imaging Centers LLC | Clinic/Center | 8962 E Desert Cove Dr # 125, Scottsdale, AZ 85260-6984 | 2012-12-03 |
| 1295061422 | Pueblo Radiology LLC | Clinic/Center | 1313 W Saint Marys Rd, Tucson, AZ 85745-3112 | 2009-10-22 |
| 1669621892 | Focused Imaging of Arizona Inc | Clinic/Center | 5680 S. Power Rd, Gilbert, AZ 85295 | 2008-09-11 |
| 1285809004 | University Imaging LLC | Clinic/Center | 6120 N 16th St, Phoenix, AZ 85016-1705 | 2008-04-23 |
| 1649449265 | Carondelet Health Network | Clinic/Center | 8290 S Houghton Road, Tucson, AZ 85747-9702 | 2008-02-28 |
| 1205030863 | Southern Arizona Diagnositc Imaging | Clinic/Center | 1845 W Orange Grove Rd Ste 103, Tucson, AZ 85704-1147 | 2007-06-14 |
| Find all providers with the same taxonomy | ||||
| City | LAKE HAVASU CITY |
| Zip Code | 86406 |
Please comment or provide details below to improve the information on VEIN CLINIC OF LAKE HAVASU.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.