Provider Demographics
NPI:1700872223
Name:KAPOOR, CHARANJIT (MD)
Entity type:Individual
Prefix:DR
First Name:CHARANJIT
Middle Name:
Last Name:KAPOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13634 N 93RD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4915
Mailing Address - Country:US
Mailing Address - Phone:623-815-2484
Mailing Address - Fax:623-815-2483
Practice Address - Street 1:13634 N 93RD AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4915
Practice Address - Country:US
Practice Address - Phone:623-815-2484
Practice Address - Fax:623-815-2483
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28498207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ515728Medicaid
H15734Medicare UPIN
AZZ105538Medicare PIN