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General NPI Number Information
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NPI Number | 1013099738
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Entity Type | Individual
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Provider Name | DILIP K BOBRA M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 2055 EAST SOUTHERN AVENUE SUITE A
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City | TEMPE
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State | AZ
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Zip | 85282-7507
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Country | US
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Telephone | 480-610-6602
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Fax |
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Provider Business Mailing Address
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Address Line | 2072 EAST LA VIEVE LANE
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City | TEMPE
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State | AZ
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Zip | 85284-3515
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Country | US
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Telephone | 480-839-2682
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 9436
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License Number State | AZ
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