Healthcare Provider Details

I. General information

NPI: 1003098070
Provider Name (Legal Business Name): DEEPTI BAHL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 S ALMA SCHOOL RD STE 310
CHANDLER AZ
85286-2812
US

IV. Provider business mailing address

1125 S ALMA SCHOOL RD STE 310
CHANDLER AZ
85286-2812
US

V. Phone/Fax

Practice location:
  • Phone: 480-684-6157
  • Fax:
Mailing address:
  • Phone: 480-684-6157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number30589
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: