Healthcare Provider Details

I. General information

NPI: 1063448389
Provider Name (Legal Business Name): KAVITA SAGGAR P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAVITA CHABRA P.A.

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 E OSBORN RD STE 4
PHOENIX AZ
85016-7146
US

IV. Provider business mailing address

1641 E OSBORN RD STE 4
PHOENIX AZ
85016-7146
US

V. Phone/Fax

Practice location:
  • Phone: 480-630-2886
  • Fax: 480-378-8124
Mailing address:
  • Phone: 480-630-2886
  • Fax: 480-378-8124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA15109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: