# PARKSIDE MEDICAL, LLC

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

## Provider details

- **NPI number:** 1467850461
- **Authorized official:** MR. DANIEL ORTIZ PA-C (MEMBER)
- **Authorized official phone:** (928) 539-0055

## Contact information

- **Practice address:** 501 W 8TH ST, YUMA, AZ 85364-2956
- **Practice address phone:** (928) 782-9000
- **Mailing address:** 501 W 8TH ST, YUMA, AZ 85364-2956
- **Mailing address phone:** (928) 782-9000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 12/08/2014
- **Last updated:** 12/08/2014