Organization
JAIDYN MED CARE LTD
Active
Other names
Powar Pain Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANDEEP POWAR M.D. (OWNER)
(928) 453-0696
Entity
Organization
Contact information
Practice address
1775 MCCULLOCH BLVD N, LAKE HAVASU CITY, AZ 86403-6549
(928) 453-0696
(928) 453-0816
Mailing address
1840 MESQUITE AVE, SUITE B, LAKE HAVASU CITY, AZ 86403-5771
(928) 453-8500
(928) 453-3660
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
24843
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
380957
—
AZ
Enumeration date
03/02/2010
Last updated
03/02/2010
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