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NPI Code Detail

MEDICARE: DR. RUPA CHUNDU MD

MEDICARE: DR. RUPA CHUNDU 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
12084P0800XPsychiatry Physician20638AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
220638OTHERAZBOARD OF MEDICAL EXAMINER

General Provider Information

NPI Number : 1700841194
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUPA CHUNDU MD
Provider Business Mailing Address
First Line : 4747 N 7TH ST
Second Line : SUITE 100
City : PHOENIX
State : AZ
Zip : 85014-3653
Country : US
Telephone Number : 602-279-7655
Fax Number : 602-264-1806
Provider Business Practice Location Address
First Line : 3001 N 33RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-5202
Country : US
Telephone Number : 602-353-0703
Fax Number : 602-353-0715
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 08/18/2022

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