Healthcare Provider Details

I. General information

NPI: 1154068864
Provider Name (Legal Business Name): ARJUN BAL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2022
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11340 W BELL RD STE 127
SURPRISE AZ
85378-9335
US

IV. Provider business mailing address

6501 W DAILEY ST
GLENDALE AZ
85306-3770
US

V. Phone/Fax

Practice location:
  • Phone: 623-259-4372
  • Fax:
Mailing address:
  • Phone: 602-377-6951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number012385
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number012385
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: