Provider Demographics
NPI:1609839562
Name:CRITICAL CARE ASSOCIATES OF YUMA, LLC
Entity Type:Organization
Organization Name:CRITICAL CARE ASSOCIATES OF YUMA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SRIDHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-317-9100
Mailing Address - Street 1:2450 S 4TH AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8573
Mailing Address - Country:US
Mailing Address - Phone:928-317-9100
Mailing Address - Fax:
Practice Address - Street 1:2400 S AVE A
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7127
Practice Address - Country:US
Practice Address - Phone:928-344-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ893794Medicaid
AZ893794Medicaid
AZDC8565Medicare PIN