Provider Demographics
NPI:1467483479
Name:ARROWHEAD GASTROENTEROLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ARROWHEAD GASTROENTEROLOGY ASSOCIATES, P.C.
Other - Org Name:SUKHDEEP S PADDA MD PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUKHDEEP
Authorized Official - Middle Name:S
Authorized Official - Last Name:PADDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-376-6328
Mailing Address - Street 1:20100 N 51ST AVE
Mailing Address - Street 2:F620
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5125
Mailing Address - Country:US
Mailing Address - Phone:623-376-6328
Mailing Address - Fax:623-566-6454
Practice Address - Street 1:20100 N 51ST AVE
Practice Address - Street 2:F620
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5125
Practice Address - Country:US
Practice Address - Phone:623-376-6328
Practice Address - Fax:623-566-6454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27340174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ495912Medicaid
AZZ73373Medicare ID - Type Unspecified