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General NPI Number Information
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NPI Number | 1700812906
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Entity Type | Organization
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Legal Business Name | KIRIT P GOSALIA MD PC
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 5620 W THUNDERBIRD RD SUITE E1
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City | GLENDALE
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State | AZ
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Zip | 85306-4636
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Country | US
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Telephone | 602-978-0154
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Fax | 602-978-2797
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Provider Business Mailing Address
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Address Line | 5620 W THUNDERBIRD RD SUITE E1
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City | GLENDALE
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State | AZ
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Zip | 85306-4636
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Country | US
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Telephone | 602-978-0154
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Fax | 602-978-2797
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KIRIT P GOSALIA
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Credential | MD
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Telephone | 602-978-0154
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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 | 11963
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License Number State | AZ
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