Provider Demographics
NPI:1134118656
Name:MEHAREEN LLP
Entity Type:Organization
Organization Name:MEHAREEN LLP
Other - Org Name:21ST CENTURY FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HARINDER
Authorized Official - Middle Name:MOHAN
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-973-3100
Mailing Address - Street 1:PO BOX 41908
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85080-1908
Mailing Address - Country:US
Mailing Address - Phone:602-973-3100
Mailing Address - Fax:602-973-0978
Practice Address - Street 1:7550 N 19TH AVE
Practice Address - Street 2:STE 201
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-7980
Practice Address - Country:US
Practice Address - Phone:602-973-3100
Practice Address - Fax:602-973-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ865404Medicaid
Y18065Medicare UPIN
AZ865404Medicaid