Healthcare Provider Details

I. General information

NPI: 1558568501
Provider Name (Legal Business Name): HARVINDER SINGH DEOGUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7242 E OSBORN RD STE 230
SCOTTSDALE AZ
85251-6494
US

IV. Provider business mailing address

3621 N WELLS FARGO AVE
SCOTTSDALE AZ
85251-5607
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-5566
  • Fax: 480-882-5565
Mailing address:
  • Phone: 480-882-5566
  • Fax: 480-882-5565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5597
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number9406909
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number44149
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number44149
License Number StateAZ
# 5
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number44149
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: