Provider Demographics
NPI:1003078973
Name:TRIVEDI, CHIRAG D (DO)
Entity type:Individual
Prefix:
First Name:CHIRAG
Middle Name:D
Last Name:TRIVEDI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3020 E CAMELBACK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5095
Mailing Address - Country:US
Mailing Address - Phone:623-972-2116
Mailing Address - Fax:623-972-0521
Practice Address - Street 1:13640 N 99TH AVE STE 600
Practice Address - Street 2:SUITE C-3
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-2861
Practice Address - Country:US
Practice Address - Phone:623-972-2116
Practice Address - Fax:623-972-0521
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ005183174400000X
NJ25MB07842100207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology