Lake Havasu OB/GYN, PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

3696 Issued in AZ

Legal business name

LAKE HAVASU OB/GYN, PC

Practice address

99 Riviera Dr
Lake Havasu City, AZ 86403-5713

Phone

(928) 680-2846

Fax

(928) 680-2845

NPI assigned

Nov 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary Jo Vita Urso, D.O.NPI 1386642783

Title

Owner

Phone

(928) 680-2846

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Jo Vita Urso, D.O.

  • Obstetrics & Gynecology Physician
  • Hemet, CA
  • NPI 1386642783
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1598944811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 RIVIERA DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035713",
            "telephone_number": "928-680-2846",
            "fax_number": "928-680-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 RIVIERA DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035713",
            "telephone_number": "928-680-2846",
            "fax_number": "928-680-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE HAVASU OB/GYN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "URSO",
        "authorized_official_first_name": "MARY JO",
        "authorized_official_middle_name": "VITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-680-2846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "AZ",
            "license": "3696",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "20A8265",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "434157",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lake Havasu Dentistry (Havasu Dentistry)
• Lake Havasu Family Eyecare, LLC
• Lake Havasu Imaging Center Inc
• Lake Havasu Medical Laboratory,LTD.
• Lake Havasu OB-GYN Care LLC
• Lake Havasu Orthodontics LLC
• Lake Havasu Primary Care PLLC
• Lake Havasu Radiology, PLLC
• Lake Havasu Too, LLC (Prestige Assisted Living at Claremont)
• Lake Havasu Unified School Distrct

• Medical Specialty Clinic/Center in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Medical Specialty Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.