Provider Demographics
NPI:1760249494
Name:ASDA INTERNAL MEDICINE LLC
Entity Type:Organization
Organization Name:ASDA INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AVINASHI
Authorized Official - Middle Name:SOMASUNDARAM
Authorized Official - Last Name:ARUN KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-402-9071
Mailing Address - Street 1:27119 N 64TH LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85083-7423
Mailing Address - Country:US
Mailing Address - Phone:602-402-9071
Mailing Address - Fax:
Practice Address - Street 1:8765 W KELTON LN UNIT B1
Practice Address - Street 2:STE 110
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382
Practice Address - Country:US
Practice Address - Phone:602-402-9071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty