Healthcare Provider Details

I. General information

NPI: 1730914649
Provider Name (Legal Business Name): SAGURO PAIN INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 E UNION HILLS DR
PHOENIX AZ
85050-3386
US

IV. Provider business mailing address

4045 E UNION HILLS DR
PHOENIX AZ
85050-3386
US

V. Phone/Fax

Practice location:
  • Phone: 602-767-0008
  • Fax:
Mailing address:
  • Phone: 602-767-0008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RUCHIR GUPTA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 602-767-0008