Provider Demographics
NPI:1891981668
Name:SOUTHWEST ENDOCRINOLOGY ASSOCIATES PLLC
Entity Type:Organization
Organization Name:SOUTHWEST ENDOCRINOLOGY ASSOCIATES PLLC
Other - Org Name:DR. MANJU SCHORR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANJU
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHORR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-344-5299
Mailing Address - Street 1:1501 W 24TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6370
Mailing Address - Country:US
Mailing Address - Phone:928-344-5299
Mailing Address - Fax:928-344-5343
Practice Address - Street 1:1501 W 24TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6370
Practice Address - Country:US
Practice Address - Phone:928-344-5299
Practice Address - Fax:928-344-5343
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST ENDOCRINOLOGY ASSOCIATES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-14
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31316207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z76451OtherMEDICARE PIN INDIVIDUAL
AZ830548OtherAHCCCS
H94755Medicare UPIN
AZZ76450Medicare PIN