Organization
LA PAZ REGIONAL HOSPITAL, INC.
Active
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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