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General NPI Number Information
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NPI Number | 1730983412
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Entity Type | Organization
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Legal Business Name | GLENDALE INFECTIOUS DISEASES, PLLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 5310 W THUNDERBIRD RD STE 201
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City | GLENDALE
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State | AZ
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Zip | 85306-4722
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Country | US
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Telephone | 623-335-4110
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Fax | 623-335-4130
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Provider Business Mailing Address
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Address Line | 5310 W THUNDERBIRD RD STE 201
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City | GLENDALE
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State | AZ
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Zip | 85306-4722
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Country | US
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Telephone | 623-335-4110
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Fax | 623-335-4130
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Authorized Official
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Title or Position | MD/OWNER
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Name | MANDEEP KAUR RAI
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Credential | MD
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Telephone | 623-335-4110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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