Healthcare Provider Details

I. General information

NPI: 1003826926
Provider Name (Legal Business Name): DIMPY KAPOOR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 01/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9305 W THOMAS RD STE 455
PHOENIX AZ
85037-3328
US

IV. Provider business mailing address

20118 N 67TH AVE #300 PMB 456
GLENDALE AZ
85308-4621
US

V. Phone/Fax

Practice location:
  • Phone: 623-399-9010
  • Fax: 623-399-9013
Mailing address:
  • Phone: 623-399-9010
  • Fax: 623-399-9013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number28711
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: