Healthcare Provider Details

I. General information

NPI: 1205950094
Provider Name (Legal Business Name): VEENA VASUDEV SARIHAN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 E BELL RD DESERT VALLEY MEDICAL PLAZA SUITE #123
PHOENIX AZ
85032-2236
US

IV. Provider business mailing address

4045 E BELL RD DESERT VALLEY MEDICAL PLAZA SUITE #123
PHOENIX AZ
85032-2236
US

V. Phone/Fax

Practice location:
  • Phone: 602-787-2626
  • Fax: 602-787-2640
Mailing address:
  • Phone: 602-787-2626
  • Fax: 602-787-2640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number19968
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: