MEDICARE: DR. SUKHDEEP S PADDA 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	207RG0100X	Gastroenterology Physician	27340	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
2	1Z5729	OTHER	AZ	HEALTHNET
3	AZ0702450	OTHER	AZ	BCBS

General Provider Information

NPI Number	:	1437143872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUKHDEEP S PADDA MD

Provider Business Mailing Address
First Line	:	20100 N 51ST AVE
Second Line	:	SUITE F620
City	:	GLENDALE
State	:	AZ
Zip	:	85308-5125
Country	:	US
Telephone Number	:	623-376-6328
Fax Number	:	622-566-6454

Provider Business Practice Location Address
First Line	:	20100 N 51ST AVE
Second Line	:	SUITE F620
City	:	GLENDALE
State	:	AZ
Zip	:	85308-5125
Country	:	US
Telephone Number	:	623-376-6328
Fax Number	:	622-566-6454

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	01/05/2009

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Directions to “ DR. SUKHDEEP S PADDA MD” Practice Location

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