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)CodeLicenseStatePrimary
Gastroenterology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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

IdentifierTypeStateIssuer
0002430OtherAZBC/BS

Other providers in Mesa, AZ

All providers in Mesa, AZ · Gastroenterology Physician in Arizona

Sources for this page

Verify at the official NPI Registry.