Provider Demographics
NPI:1730496274
Name:SACHDEVA, YESSICA RAMOS (MD)
Entity Type:Individual
Prefix:
First Name:YESSICA
Middle Name:RAMOS
Last Name:SACHDEVA
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 1:2201 W FAIRVIEW ST
Mailing Address - Street 2:STE 9
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-4704
Mailing Address - Country:US
Mailing Address - Phone:602-569-3999
Mailing Address - Fax:602-569-3887
Practice Address - Street 1:616 E SOUTHERN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-4941
Practice Address - Country:US
Practice Address - Phone:602-569-3999
Practice Address - Fax:480-569-3887
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ45975208M00000X, 207R00000X
AZ390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ724649Medicaid
AZZ179333Medicare PIN