Organization
SWDC WALK-IN CLINIC
Active
Organization
SWDC WALK-IN CLINIC
Active
Parent organization
SOUTHWEST DIABETES CENTER PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWEST DIABETES CENTER PLLC
Authorized official
SERGIO PENAHERRERA MD (OWNER)
(928) 344-6450
Entity
Organization
Contact information
Practice address
1881 W 24TH ST, STE A, YUMA, AZ 85364-6297
(928) 344-6450
(928) 344-6480
Mailing address
PO BOX 590, YUMA, AZ 85366-2325
(928) 344-6450
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
AZ
Other
Enumeration date
11/07/2011
Last updated
03/27/2012
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