Individual
DR. VASANTH KIRAN COORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 546-2923
Mailing address
2108 E THOMAS RD, PHOENIX, AZ 85016-7761
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
45843
AZ
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
45843
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
733769
—
AZ
Enumeration date
09/30/2009
Last updated
02/18/2025
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