Provider Demographics
NPI:1003387515
Name:TOTAL CARE HEALTH CLINIC
Entity Type:Organization
Organization Name:TOTAL CARE HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TZIMARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-294-1835
Mailing Address - Street 1:941 N 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-7627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:941 N 11TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-7627
Practice Address - Country:US
Practice Address - Phone:517-294-1835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-09
Last Update Date:2018-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty