# COLTON HEALTH AZ, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124635396
- **Authorized official:** MR. SUKHJIT SINGH GHUMAN (GROUP CHAIRMAN AND CEO)
- **Authorized official phone:** (602) 702-3955

## Contact information

- **Practice address:** 890 AIRWAY AVE, KINGMAN, AZ 86409-3588
- **Practice address phone:** (928) 681-1234
- **Practice address fax:** (928) 681-1811
- **Mailing address:** 9457 E ADOBE DR, SCOTTSDALE, AZ 85255-5077
- **Mailing address phone:** (602) 702-3955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/30/2020
- **Last updated:** 04/13/2023