Provider Demographics
NPI:1609038652
Name:CHHABRA, RUCHI (MD)
Entity Type:Individual
Prefix:DR
First Name:RUCHI
Middle Name:
Last Name:CHHABRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 W. THUNDERBIRD
Mailing Address - Street 2:BANNER THUNDERBIRD MEDICAL CENTER
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306
Mailing Address - Country:US
Mailing Address - Phone:602-865-2627
Mailing Address - Fax:602-865-2632
Practice Address - Street 1:5555 W. THUNDERBIRD
Practice Address - Street 2:BANNER THUNDERBIRD MEDICAL CENTER
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306
Practice Address - Country:US
Practice Address - Phone:602-865-2627
Practice Address - Fax:602-865-2632
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ40989282N00000X
AZ40989207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No282N00000XHospitalsGeneral Acute Care Hospital
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z134022Medicare PIN
AZZ138472Medicare PIN