Provider Demographics
NPI:1770629818
Name:LA PAZ FAMILY CARE
Entity Type:Organization
Organization Name:LA PAZ FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DELMA
Authorized Official - Middle Name:B
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-884-4771
Mailing Address - Street 1:4945 S. JOSEPH AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85757
Mailing Address - Country:US
Mailing Address - Phone:520-884-4771
Mailing Address - Fax:520-884-4874
Practice Address - Street 1:1701 W. ST. MARYS RD
Practice Address - Street 2:#125
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745
Practice Address - Country:US
Practice Address - Phone:520-884-4771
Practice Address - Fax:520-884-4874
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LA PAZ FAMILY CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN026569207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ7211863OtherAETNA
AZ65655OtherHEALTHNET
AZ390443Medicaid
AZ7211863OtherAETNA
AZ67637Medicare PIN