Healthcare Provider Details

I. General information

NPI: 1396207916
Provider Name (Legal Business Name): MANMEET KAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8405 N PIMA CENTER PKWY STE 201
SCOTTSDALE AZ
85258-4670
US

IV. Provider business mailing address

2500 W UTOPIA RD STE 100
PHOENIX AZ
85027-4172
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number73869
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: