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General NPI Number Information
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NPI Number | 1740324409
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Entity Type | Organization
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Legal Business Name | DESERT COMMUNITY MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 13215 N. VERDE RIVER DR SUITE 6
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268
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Country | US
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Telephone | 480-816-3130
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Fax | 480-816-3134
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Provider Business Mailing Address
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Address Line | PO BOX 41600
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City | MESA
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State | AZ
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Zip | 85274
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Country | US
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Telephone | 480-816-3130
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Fax | 480-816-3134
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Authorized Official
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Title or Position | MD - OWNER
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Name | HIMANSHU H SHUKLA
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Credential | MD
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Telephone | 480-816-3130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4278
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 34435
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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