Healthcare Provider Details

I. General information

NPI: 1063681336
Provider Name (Legal Business Name): SHUBHANGI SHAHAJI PECHE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5422 W THUNDERBIRD RD STE 13
GLENDALE AZ
85306-4717
US

IV. Provider business mailing address

4505 E CHANDLER BLVD STE 200
PHOENIX AZ
85048-7688
US

V. Phone/Fax

Practice location:
  • Phone: 480-961-2365
  • Fax: 480-961-2382
Mailing address:
  • Phone: 480-961-2365
  • Fax: 480-961-2382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number57749
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: