Provider Demographics
NPI:1831863406
Name:CAVE CREEK CONSULTANT PLLC
Entity type:Organization
Organization Name:CAVE CREEK CONSULTANT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HEMANG
Authorized Official - Middle Name:G
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-252-3286
Mailing Address - Street 1:PO BOX 2510
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85214-2510
Mailing Address - Country:US
Mailing Address - Phone:602-432-0146
Mailing Address - Fax:
Practice Address - Street 1:2553 E ROSE GARDEN LANE
Practice Address - Street 2:SUITE 77348
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050
Practice Address - Country:US
Practice Address - Phone:602-218-9483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-05
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty