Individual provider Active NPI

Kudzai R Dombo, M.D.

  • Obstetrics & Gynecology Physician
  • Chandler, AZ
National Provider Identifier
1326010505
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
46122 Issued in AZ
Practice address
2055 W Frye Rd
Suite 9
Chandler, AZ 85224-6277
Phone
(480) 821-3616
Fax
(480) 857-2667
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 46122 AZ Primary

Addresses

Primary practice location

2055 W Frye Rd
Suite 9
Chandler, AZ 85224-6277

Mailing address

PO Box 6730
Chandler, AZ 85246-6730
Phone (480) 821-3610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160921000732 CA Practitioner - Obstetrics/Gynecology 8729011663 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. Family Medicine CurrentSince Mar 8, 2017 Accepting new patients
Regional Womens Health Group LLC Obstetrics & Gynecology Past Accepting new patients
Healthy Pregnancy Perinatology, LLC Past Accepting new patients

Locations

501 S Buena Vista St
Burbank, CA 91505
Phone (818) 783-0800

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

1 Hoag Dr
Newport Beach, CA 92663
Phone (877) 742-4624

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1326010505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6730",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466730",
            "telephone_number": "480-821-3610",
            "fax_number": "480-821-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 W FRYE RD",
            "address_2": "SUITE 9",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246277",
            "telephone_number": "480-821-3616",
            "fax_number": "480-857-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMBO",
        "first_name": "KUDZAI",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "46122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.