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General NPI Number Information
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NPI Number | 1689157166
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Entity Type | Organization
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Legal Business Name | HEALTHY LIVING DIABETES AND ENDOCRINOLOGY PLC
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 908 W CHANDLER BLVD B-4 BUILDING B, SUITE 4
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City | CHANDLER
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State | AZ
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Zip | 85225-2548
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Country | US
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Telephone | 480-269-6448
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Fax | 779-204-2331
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Provider Business Mailing Address
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Address Line | 908 W CHANDLER BLVD B-4 BUILDING B, SUITE 4
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City | CHANDLER
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State | AZ
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Zip | 85225-2548
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Country | US
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Telephone | 480-269-6448
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Fax | 779-204-2331
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Authorized Official
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Title or Position | MEMBER/MANAGING EMPLOYEE
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Name | DR. NAGA NALINI TIRUMALASETTY
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Credential | MD, ECNU, FACE
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Telephone | 480-269-6448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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