Healthcare Provider Details

I. General information

NPI: 1124769633
Provider Name (Legal Business Name): DEESHA PRASHANT PARMAR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 08/14/2025
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 E MCDOWELL RD
PHOENIX AZ
85006-2502
US

IV. Provider business mailing address

925 E MCDOWELL RD
PHOENIX AZ
85006
US

V. Phone/Fax

Practice location:
  • Phone: 602-521-3700
  • Fax: 602-521-3701
Mailing address:
  • Phone: 602-251-3700
  • Fax: 602-521-3701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9047
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: