Individual
VIVEK MALLADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1955 W FRYE RD, CHANDLER, AZ 85224-6282
(480) 728-3000
(480) 507-2971
Mailing address
PO BOX 1847, GILBERT, AZ 85299-1847
(480) 507-2961
(480) 507-2971
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125054286
IL
207L00000X
Anesthesiology Physician
Primary
47505
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
831389
—
AZ
01
—
P01306466
MEDICARE RR
AZ
Enumeration date
06/21/2010
Last updated
03/07/2023
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