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NPI Code Detail

MEDICARE: SOUTHWEST KIDNEY NORTH PHOENIX LLC

MEDICARE: SOUTHWEST KIDNEY NORTH PHOENIX LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician

General Provider Information

NPI Number : 1003206418
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST KIDNEY NORTH PHOENIX LLC
Provider Business Mailing Address
First Line : 2149 E WARNER RD STE 102
Second Line :
City : TEMPE
State : AZ
Zip : 85284-3495
Country : US
Telephone Number : 480-610-6100
Fax Number :
Provider Business Practice Location Address
First Line : 337 E CORONADO RD STE 201
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-1583
Country : US
Telephone Number : 602-252-8081
Fax Number : 602-252-1520
Authorized Official
Title or Position : VICE PRESIDENT OF FINANCE
Name : DR. GURDEV SINGH
Credential : M.D,
Telephone Number : 480-610-6100
Provider Enumeration Date : 01/23/2015
Last Update Date : 01/23/2015

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Directions to “SOUTHWEST KIDNEY NORTH PHOENIX LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.