Provider Demographics
NPI:1508017385
Name:GILA LUNG, PC
Entity Type:Organization
Organization Name:GILA LUNG, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMRANJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:GALHOTRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:928-472-8339
Mailing Address - Street 1:401 S MARIPOSA ST
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85541-5168
Mailing Address - Country:US
Mailing Address - Phone:928-472-8339
Mailing Address - Fax:928-472-4497
Practice Address - Street 1:401 S MARIPOSA ST
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5168
Practice Address - Country:US
Practice Address - Phone:928-472-8339
Practice Address - Fax:928-472-4497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ27506207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty