Healthcare Provider Details

I. General information

NPI: 1609821016
Provider Name (Legal Business Name): SNEHAL MOHAN BHOOLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N GILBERT RD STE 200
GILBERT AZ
85234-2394
US

IV. Provider business mailing address

513 W CANYON WAY
CHANDLER AZ
85248-5124
US

V. Phone/Fax

Practice location:
  • Phone: 480-530-4220
  • Fax: 833-465-1456
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number40789
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: