Healthcare Provider Details

I. General information

NPI: 1285999318
Provider Name (Legal Business Name): ASHRITHA PENAGALURI M.D.,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2012
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 N 3RD ST STE 2000
PHOENIX AZ
85020-2403
US

IV. Provider business mailing address

2500 W UTOPIA RD STE 100
PHOENIX AZ
85027-4172
US

V. Phone/Fax

Practice location:
  • Phone: 480-246-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number81882
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number81882
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number81882
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: