Healthcare Provider Details

I. General information

NPI: 1740939651
Provider Name (Legal Business Name): AARON S SIDHU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13677 W MCDOWELL RD
GOODYEAR AZ
85395-2600
US

IV. Provider business mailing address

2655 E CANYON PL
CHANDLER AZ
85249-5101
US

V. Phone/Fax

Practice location:
  • Phone: 480-347-6503
  • Fax:
Mailing address:
  • Phone: 480-347-6503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME175395
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: