MEDICARE: MR. KUNAL DEORA M.D

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	207R00000X	Internal Medicine Physician	79116	AZ
2	390200000X	Student in an Organized Health Care Education/Training Program	R80503	AZ

General Provider Information

NPI Number	:	1265124697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KUNAL DEORA M.D

Provider Business Mailing Address
First Line	:	1800 E FLORENCE BLVD
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-5303
Country	:	US
Telephone Number	:	520-381-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 E FLORENCE BLVD
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-5303
Country	:	US
Telephone Number	:	520-381-6300
Fax Number	:

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

Provider Enumeration Date	:	05/24/2023
Last Update Date	:	06/09/2026

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