MEDICARE: DR. THIHALOLIPAVAN SAYALOLIPAVAN MD

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
1	207Q00000X	Family Medicine Physician	204887	NY
2	207Q00000X	Family Medicine Physician	65664	AZ

General Provider Information

NPI Number	:	1053309039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THIHALOLIPAVAN SAYALOLIPAVAN MD

Provider Business Mailing Address
First Line	:	2070 E BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-6948
Country	:	US
Telephone Number	:	602-834-9071
Fax Number	:	877-541-4239

Provider Business Practice Location Address
First Line	:	2070 E BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-6948
Country	:	US
Telephone Number	:	602-834-9071
Fax Number	:	877-541-4239

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	03/17/2026

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