Provider Demographics
NPI:1457502908
Name:TUCSON INTERNAL MEDICINE & GERIATRICS ASSOCIATES, PC
Entity Type:Organization
Organization Name:TUCSON INTERNAL MEDICINE & GERIATRICS ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:MITTAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-219-3285
Mailing Address - Street 1:2001 W ORANGE GROVE RD
Mailing Address - Street 2:STE 510
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1139
Mailing Address - Country:US
Mailing Address - Phone:520-219-3285
Mailing Address - Fax:520-219-3285
Practice Address - Street 1:2001 W ORANGE GROVE RD
Practice Address - Street 2:STE 510
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1139
Practice Address - Country:US
Practice Address - Phone:520-219-3285
Practice Address - Fax:520-219-3285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center