Provider Demographics
NPI:1336224369
Name:DESERT OASIS MEDICAL CENTER, PLLC
Entity Type:Organization
Organization Name:DESERT OASIS MEDICAL CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:WAHEED
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEHRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-758-0121
Mailing Address - Street 1:1225 HANCOCK RD STE C
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-5961
Mailing Address - Country:US
Mailing Address - Phone:928-758-0121
Mailing Address - Fax:928-758-0128
Practice Address - Street 1:1225 HANCOCK RD STE C
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-5961
Practice Address - Country:US
Practice Address - Phone:928-758-0121
Practice Address - Fax:928-758-0128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ023454207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ323296Medicaid
AZAZ0881610OtherBLUE CROSS
AZAZ0881610OtherBLUE CROSS