Healthcare Provider Details

I. General information

NPI: 1225692346
Provider Name (Legal Business Name): NAVKARAN SINGH GIRGLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2019
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date: 12/09/2019
Reactivation Date: 12/16/2019

III. Provider practice location address

8088 W WHITNEY DR
PEORIA AZ
85345-6564
US

IV. Provider business mailing address

2929 E THOMAS RD
PHOENIX AZ
85016-8034
US

V. Phone/Fax

Practice location:
  • Phone: 602-655-2000
  • Fax:
Mailing address:
  • Phone: 602-470-5000
  • Fax: 602-470-5064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number67301
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number67301
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: