Healthcare Provider Details

I. General information

NPI: 1558659441
Provider Name (Legal Business Name): CHINTAN PANKAJ PATEL M.D. ,MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 05/17/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16427 N SCOTTSDALE RD STE 100
SCOTTSDALE AZ
85254-8197
US

IV. Provider business mailing address

3605 E HALF HITCH PL
PHOENIX AZ
85050-6502
US

V. Phone/Fax

Practice location:
  • Phone: 480-718-5072
  • Fax:
Mailing address:
  • Phone: 410-302-5956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number56407
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: