Healthcare Provider Details

I. General information

NPI: 1275975468
Provider Name (Legal Business Name): GUNJAN CHOUDHARY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2013
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 S VAL VISTA DR
GILBERT AZ
85297-7323
US

IV. Provider business mailing address

3100 W RAY RD STE 201
CHANDLER AZ
85226-2472
US

V. Phone/Fax

Practice location:
  • Phone: 888-488-7640
  • Fax: 602-783-1026
Mailing address:
  • Phone: 888-488-7640
  • Fax: 602-783-1026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number76394
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.137001
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT204081
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number35.137001
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: