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General NPI Number Information
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NPI Number | 1386606200
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Entity Type | Individual
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Provider Name | SANJEEV KHURANA MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 20100 N 51ST AVE STE B220
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City | GLENDALE
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State | AZ
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Zip | 85308-5145
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Country | US
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Telephone | 623-825-5200
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Fax | 623-825-5201
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Provider Business Mailing Address
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Address Line | 20100 N 51ST AVE STE B220
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City | GLENDALE
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State | AZ
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Zip | 85308-5145
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Country | US
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Telephone | 623-825-5200
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Fax | 623-825-5201
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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 | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 35045
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License Number State | AZ
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