MEDICARE: SHIRAZ H LADHA MD PC

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	261Q00000X	Clinic/Center	16757	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225015159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIRAZ H LADHA MD PC

Provider Business Mailing Address
First Line	:	14001 N 7TH ST
Second Line	:	SUITE G114
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4382
Country	:	US
Telephone Number	:	602-298-6930
Fax Number	:	602-298-6918

Provider Business Practice Location Address
First Line	:	14001 N 7TH ST
Second Line	:	SUITE G114
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4382
Country	:	US
Telephone Number	:	602-298-6930
Fax Number	:	602-298-6918

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. SHIRAZ H LADHA
Credential	:	M.D.
Telephone Number	:	602-298-6930

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	11/21/2011

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