Healthcare Provider Details

I. General information

NPI: 1891795993
Provider Name (Legal Business Name): ASHOK GARG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 06/16/2024
Certification Date: 06/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 S DOBSON RD STE A110
MESA AZ
85202-4739
US

IV. Provider business mailing address

5006 E CANNON DR
PARADISE VALLEY AZ
85253-1062
US

V. Phone/Fax

Practice location:
  • Phone: 480-264-6655
  • Fax:
Mailing address:
  • Phone: 480-289-8759
  • Fax: 602-482-0210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number27507
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: