Your Visiting Doctor, PLLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

35176 Issued in AZ

Legal business name

YOUR VISITING DOCTOR, PLLC

Practice address

20325 N 51St Ave
BLDG 6 Suite 142
Glendale, AZ 85308-5674

Phone

(623) 587-4500

Fax

(602) 680-7576

NPI assigned

Jun 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Deepa Dharmarajan, M.D.

Title

Owner

Phone

(623) 910-9730

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468540800000",
    "number": "1417118563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1149",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853801149",
            "telephone_number": "623-910-9730",
            "fax_number": "602-680-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20325 N 51ST AVE",
            "address_2": "BLDG 6 SUITE 142",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085674",
            "telephone_number": "623-587-4500",
            "fax_number": "602-680-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR VISITING DOCTOR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2016-07-15",
        "status": "A",
        "authorized_official_last_name": "DHARMARAJAN",
        "authorized_official_first_name": "DEEPA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-910-9730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "35176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Geriatric Medicine (Family Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.