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General NPI Number Information
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NPI Number | 1104880996
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Entity Type | Individual
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Provider Name | GORDI KHERA MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 07/29/2020
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Provider Practice Location Address
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Address Line | 5620 W THUNDERBIRD RD STE E4
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City | GLENDALE
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State | AZ
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Zip | 85306-4651
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Country | US
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Telephone | 602-296-7224
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Fax | 602-535-5284
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Provider Business Mailing Address
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Address Line | 5620 W THUNDERBIRD RD STE E4
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City | GLENDALE
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State | AZ
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Zip | 85306-4651
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Country | US
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Telephone | 602-296-7224
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Fax | 602-535-5284
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 20871
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License Number State | AZ
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