Organization
MOHAVE PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILANGOVAN GOVINDARAJAN M.D.,CMD (PRESIDENT)
(928) 692-1900
Entity
Organization
Contact information
Practice address
975 SYCAMORE AVE, KINGMAN, AZ 86409-3548
(928) 692-1900
(928) 692-7334
Mailing address
2183 SENECA ST, KINGMAN, AZ 86401-6511
(928) 763-5948
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25797
AZ
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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