Healthcare Provider Details

I. General information

NPI: 1356307839
Provider Name (Legal Business Name): MANKANWAL SACHDEV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 S DOBSON RD STE 101
CHANDLER AZ
85224-5603
US

IV. Provider business mailing address

PO BOX 33269
PHOENIX AZ
85067-3269
US

V. Phone/Fax

Practice location:
  • Phone: 480-728-4981
  • Fax: 480-728-4985
Mailing address:
  • Phone: 602-406-4786
  • Fax: 916-636-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number31863
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number25IA12966100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: