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General NPI Number Information
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NPI Number | 1578517793
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Entity Type | Organization
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Legal Business Name | G & K MEDICAL ASSOCIATES, P.C.
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 10450 W MCDOWELL RD SUITE 101
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City | AVONDALE
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State | AZ
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Zip | 85392-4802
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Country | US
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Telephone | 623-935-1000
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Fax | 623-935-1022
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Provider Business Mailing Address
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Address Line | 10450 W MCDOWELL RD SUITE 101
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City | AVONDALE
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State | AZ
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Zip | 85392-4802
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Country | US
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Telephone | 623-935-1000
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Fax | 623-935-1022
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Authorized Official
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Title or Position | PRESIDENT/DOCTOR
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Name | DR. RAVI BHUSHAN GALHOTRA
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Credential | M.D
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Telephone | 623-935-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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