Associated Desert Gastroenterologists PC
Organization Active NPI Gastroenterology Physician · Mesa, AZ
NPI 1336320613 · NPPES record last updated Nov 4, 2014
Key facts
- NPI
- 1336320613
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Gastroenterology Physician 207RG0100X
- License
- 12854 (AZ)
- Legal business name
- ASSOCIATED DESERT GASTROENTEROLOGISTS PC
- Practice address
- 215 S Power Rd
# 102
Mesa, AZ 85206-5235 - Phone
- (480) 985-9005
- Fax
- (480) 396-9974
- NPI assigned
- Nov 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Prem C Kumar, MD
- Title
- Owner
- Phone
- (480) 985-9005
National Provider Directory
Locations
2563 S Val Vista Dr
Gilbert, AZ 85295
Phone (480) 290-2533
2600 E Southern Ave
Ste 11
Tempe, AZ 85282
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician |
207RG0100X | 12854 | AZ | Yes |
Addresses
Primary practice location
215 S Power Rd
# 102
Mesa, AZ 85206-5235
Mailing address
215 S Power Rd
Suite 102
Mesa, AZ 85206-5235
Phone (480) 985-9005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0002430 | Other | AZ | BC/BS |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.