Provider Demographics
NPI:1932378338
Name:HAAGGZ MEDICAL CLINIC, CO
Entity Type:Organization
Organization Name:HAAGGZ MEDICAL CLINIC, CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZEPYUR
Authorized Official - Middle Name:
Authorized Official - Last Name:NENEDZHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-262-2309
Mailing Address - Street 1:13925 MEEKER BLVD., STE 17
Mailing Address - Street 2:
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375
Mailing Address - Country:US
Mailing Address - Phone:623-262-2309
Mailing Address - Fax:
Practice Address - Street 1:13925 MEEKER BLVD., STE 17
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375
Practice Address - Country:US
Practice Address - Phone:623-262-2309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty