Healthcare Provider Details

I. General information

NPI: 1316715576
Provider Name (Legal Business Name): EKONMEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18301 N 79TH AVE STE G190
GLENDALE AZ
85308-6093
US

IV. Provider business mailing address

18301 N 79TH AVE STE G190
GLENDALE AZ
85308-6093
US

V. Phone/Fax

Practice location:
  • Phone: 602-932-8597
  • Fax: 602-848-4696
Mailing address:
  • Phone: 602-932-8597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GURDEV SINGH
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 602-882-6955