MEDICARE: RAKESH MALHOTRA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	16158	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205823937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAKESH MALHOTRA MD

Provider Business Mailing Address
First Line	:	9520 W PALM LN
Second Line	:	200
City	:	PHOENIX
State	:	AZ
Zip	:	85037-4403
Country	:	US
Telephone Number	:	877-809-5092
Fax Number	:	623-815-9253

Provider Business Practice Location Address
First Line	:	7725 N 43RD AVE
Second Line	:	510
City	:	PHOENIX
State	:	AZ
Zip	:	85051-5770
Country	:	US
Telephone Number	:	877-809-5092
Fax Number	:	602-843-1560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	12/16/2021

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