1659559417 NPI number — CHATUR J BABARIA MD PC

Table of content: (NPI 1659559417)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659559417 NPI number — CHATUR J BABARIA MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHATUR J BABARIA MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
QUEEN CREEK FAMILY MEDICINE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659559417
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22707 S ELLSWORTH RD
Provider Second Line Business Mailing Address:
STE H-103
Provider Business Mailing Address City Name:
QUEEN CREEK
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85142-6131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-677-3494
Provider Business Mailing Address Fax Number:
480-677-4319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22707 S ELLSWORTH RD
Provider Second Line Business Practice Location Address:
STE H-103
Provider Business Practice Location Address City Name:
QUEEN CREEK
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85142-6131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-677-3494
Provider Business Practice Location Address Fax Number:
480-677-4319
Provider Enumeration Date:
02/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BABARIA
Authorized Official First Name:
CHATUR
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
480-677-3494

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  32966 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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