Healthcare Provider Details

I. General information

NPI: 1922236231
Provider Name (Legal Business Name): RICHA DUGGAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RICHA SOOD

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 E BASELINE RD
PHOENIX AZ
85042-6551
US

IV. Provider business mailing address

3003 N CENTRAL AVE STE 1600
PHOENIX AZ
85012-2908
US

V. Phone/Fax

Practice location:
  • Phone: 602-243-7277
  • Fax: 602-243-1235
Mailing address:
  • Phone: 602-323-3344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number46223
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: