Provider Demographics
NPI:1871884700
Name:EAST VALLEY GASTROENTEROLOGY & HEPATOLOGY
Entity type:Organization
Organization Name:EAST VALLEY GASTROENTEROLOGY & HEPATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SWARNJIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-786-6655
Mailing Address - Street 1:PO BOX 6190
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6190
Mailing Address - Country:US
Mailing Address - Phone:480-786-6655
Mailing Address - Fax:480-505-0764
Practice Address - Street 1:803 N SALK DR
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5447
Practice Address - Country:US
Practice Address - Phone:480-786-6655
Practice Address - Fax:480-505-0764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ141552OtherMEDICARE PTAN