Rumbha Virasoontara Bhandhusavee, M.D.

Individual provider Active NPI Pediatric Adolescent Medicine Physician · Glendale, AZ

NPI 1093733644 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1093733644
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Adolescent Medicine Physician 2080A0000X
License
6664 (AZ)
Practice address
13980 N 67TH Ave
Suite Number 1
Glendale, AZ 85306-3715
Phone
(623) 979-9545
Fax
(623) 878-2126
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6664AZMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 6664 AZ Yes

Addresses

Primary practice location

13980 N 67TH Ave
Suite Number 1
Glendale, AZ 85306-3715

Mailing address

13980 N 67TH Ave
Suite Number 1
Glendale, AZ 85306-3715
Phone (623) 979-9545

Other names

  • Dr. Rumbha Bhandhusavee Other name

Other providers in Glendale, AZ

All providers in Glendale, AZ · Pediatric Adolescent Medicine Physician in Arizona

Sources for this page

Verify at the official NPI Registry.