Healthcare Provider Details

I. General information

NPI: 1538380399
Provider Name (Legal Business Name): DARREN M CHUGG D.M.D., PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 W BELL RD STE 170
GLENDALE AZ
85308-3785
US

IV. Provider business mailing address

6120 W BELL RD STE 170
GLENDALE AZ
85308-3785
US

V. Phone/Fax

Practice location:
  • Phone: 623-487-1122
  • Fax: 623-487-1333
Mailing address:
  • Phone: 623-487-1122
  • Fax: 623-487-1333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD009455
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP5982
License Number StateID
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS018481
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: