MEDICARE: ARROWHEAD GASTROENTEROLOGY ASSOCIATES, P.C.

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	174400000X	Specialist	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

General Provider Information

NPI Number	:	1467483479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARROWHEAD GASTROENTEROLOGY ASSOCIATES, P.C.

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

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

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SUKHDEEP S PADDA
Credential	:	M.D.
Telephone Number	:	623-376-6328

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	02/02/2009

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