LAKE HAVASU PRIMARY CARE PLLC
NPI 1194116186
Internal Medicine in Lake Havasu City, AZ

Active since February 11, 2015CLIA 03D2093418 · Waiver
1830 MESQUITE AVE, SUITE B, LAKE HAVASU CITY, AZ 86403(928) 453-0777(928) 453-0778 Get Directions Write a Review

NPPES record last updated: February 11, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Lake Havasu Primary Care Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKE HAVASU PRIMARY CARE PLLC (NPI 1194116186) is a healthcare organization registered as an internal medicine in Lake Havasu City, Arizona and active in the NPI registry since February 2015. The organization holds a CLIA Waiver certificate valid through March 25, 2027 and lists Essa J Sidiqi, Owner/member/manager, as its authorized official.

NPPES Registry Identity

NPI1194116186
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLAKE HAVASU PRIMARY CARE PLLC
Location Address1830 MESQUITE AVE, SUITE BLake Havasu City, AZ 86403-5885
Mailing Address1830 Mesquite Ave, Suite BLake Havasu City, AZ 86403-5885 · (928) 453-0777 · Fax (928) 453-0778
Fax(928) 453-0778
Organization SubpartNo
Authorized OfficialEssa J SidiqiOwner/member/manager · (928) 453-0777
Enumeration DateFebruary 11, 2015
NPI 1194116186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in AZ · 48667
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1830 MESQUITE AVE, Lake Havasu City, AZ 86403

Other Identifiers 1

OtherP-1982371-1AZ · Pllc Registration Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2093418

Lake Havasu Primary Care · Lake Havasu City, AZ
Active · expires Mar 25, 2027
CLIA Number03D2093418
Laboratory TypePhysician Office
Certificate Effective DateMarch 26, 2025
Certificate Expiration DateMarch 25, 2027
Laboratory DirectorEssa J. Sidiqi
Laboratory Phone(928) 453-0777
Laboratory LocationLake Havasu Primary Care89 Civic Center Blvd, Lake Havasu City, AZ 86403
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant (Medical)
1830 MESQUITE AVE, SUITE A
LAKE HAVASU CITY, AZ 86403
Family Medicine
1830 MESQUITE AVE, SUITE B
LAKE HAVASU CITY, AZ 86403
Internal Medicine
1830 MESQUITE AVE, STE. A
LAKE HAVASU CITY, AZ 86403
Internal Medicine (Pulmonary Disease)
1830 MESQUITE AVE, SUITE C
LAKE HAVASU CITY, AZ 86403
Internal Medicine (Pulmonary Disease)
1830 MESQUITE AVE, STE C
LAKE HAVASU CITY, AZ 86403

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Havasu Primary Care PLLC's NPI number?

The NPI number for Lake Havasu Primary Care PLLC is 1194116186. It was assigned to this organization in the NPPES registry on February 11, 2015.

Where is Lake Havasu Primary Care PLLC located?

Lake Havasu Primary Care PLLC is located at 1830 Mesquite Ave Suite B, Lake Havasu City, AZ 86403. The listed phone number is (928) 453-0777.

What is Lake Havasu Primary Care PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Lake Havasu Primary Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2093418) is associated with this NPI, valid through March 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lake Havasu Primary Care PLLC was last updated on February 11, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.