Healthcare Provider Details

I. General information

NPI: 1467659193
Provider Name (Legal Business Name): RAMIZ AUDI RAMIZ AUDI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RAMIZ AUDI MD

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 E CHANDLER BLVD STE 1
CHANDLER AZ
85225-5117
US

IV. Provider business mailing address

1915 E CHANDLER BLVD STE 1
CHANDLER AZ
85225-5117
US

V. Phone/Fax

Practice location:
  • Phone: 480-306-5151
  • Fax: 480-306-4648
Mailing address:
  • Phone: 480-306-5151
  • Fax: 480-306-4648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberLL16619
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101256442
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number55098
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: