Provider Demographics
NPI:1235386715
Name:DIGESTIVE & LIVER DISEASES, P.C.
Entity Type:Organization
Organization Name:DIGESTIVE & LIVER DISEASES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAWEL
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:RANDHAWA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-262-1171
Mailing Address - Street 1:577 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:LATHROP
Mailing Address - State:CA
Mailing Address - Zip Code:95330-8406
Mailing Address - Country:US
Mailing Address - Phone:623-262-1171
Mailing Address - Fax:
Practice Address - Street 1:577 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:LATHROP
Practice Address - State:CA
Practice Address - Zip Code:95330-8406
Practice Address - Country:US
Practice Address - Phone:623-262-1171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ024657174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZMD24657Medicare UPIN