Organization
LA PAZ REGIONAL HOSPITAL, INC.
Active
Other names
Bouse Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GUADALUPE MICHELLE BALDENEGRO (MEDICAL STAFF COORDINATOR)
(928) 669-7382
Entity
Organization
Contact information
Practice address
44031 E PLUMOSA ROAD, BOUSE, AZ 85325
(928) 669-8512
(928) 851-1828
Mailing address
1200 W MOHAVE RD, PARKER, AZ 85344-6349
(928) 669-9201
(928) 669-7417
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG7880
MEDICARE RR
AZ
Enumeration date
07/12/2006
Last updated
04/27/2026
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