Healthcare Provider Details

I. General information

NPI: 1003127457
Provider Name (Legal Business Name): JASKANWAL SINGH BISLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S ALMA SCHOOL RD STE 204
CHANDLER AZ
85248
US

IV. Provider business mailing address

3200 S ALMA SCHOOL RD STE 204
CHANDLER AZ
85248-3773
US

V. Phone/Fax

Practice location:
  • Phone: 480-728-5500
  • Fax: 480-728-5550
Mailing address:
  • Phone: 480-728-5500
  • Fax: 480-728-5550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number47484
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: