Healthcare Provider Details

I. General information

NPI: 1437039062
Provider Name (Legal Business Name): INTEGRATED LAB AND HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7335 E ACOMA DR STE 202
SCOTTSDALE AZ
85260-3117
US

IV. Provider business mailing address

7335 E ACOMA DR STE 202
SCOTTSDALE AZ
85260-3117
US

V. Phone/Fax

Practice location:
  • Phone: 480-219-8991
  • Fax:
Mailing address:
  • Phone: 480-219-8991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ROHIT NANIK CHANDIRAMANI
Title or Position: CEO
Credential:
Phone: 480-818-8871