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General NPI Number Information
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NPI Number | 1598125791
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Entity Type | Organization
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Legal Business Name | RAGHAV LLC
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 07/01/2024
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Provider Practice Location Address
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Address Line | 12361 W BOLA DR STE 109
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City | SURPRISE
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State | AZ
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Zip | 85378-9021
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Country | US
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Telephone | 623-227-1000
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Fax | 623-227-2000
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Provider Business Mailing Address
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Address Line | 12361 W BOLA DR STE 109
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City | SURPRISE
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State | AZ
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Zip | 85378-9021
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Country | US
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Telephone | 623-227-1000
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Fax | 623-227-2000
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Authorized Official
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Title or Position | OWNER
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Name | DR. HARESH BOGHARA
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Credential | M.D.
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Telephone | 214-250-2140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 41238
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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