Provider Demographics
NPI:1891945275
Name:YUMA HEART INSTITUTE, LLC
Entity Type:Organization
Organization Name:YUMA HEART INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:T P
Authorized Official - Last Name:CHEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-344-8748
Mailing Address - Street 1:1773 WEST 24TH STREET SUITE B
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364
Mailing Address - Country:US
Mailing Address - Phone:928-344-8748
Mailing Address - Fax:928-341-8750
Practice Address - Street 1:1773 WEST 24TH STREET SUITE B
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364
Practice Address - Country:US
Practice Address - Phone:928-344-8748
Practice Address - Fax:928-341-8750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11124207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1518990902OtherGROUP NPI
AZ1962507632OtherINDIVIDUAL NPI NUMBER
AZ228529-01Medicaid
AZE00833Medicare UPIN
AZZ75661Medicare PIN
AZ1962507632OtherINDIVIDUAL NPI NUMBER