Individual
DR. KALYANI S MOOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19829 N 27TH AVE, PHOENIX, AZ 85027-4001
(623) 505-9880
(623) 505-9880
Mailing address
3655 W ANTHEM WAY, SUITE A109 PMB 313, ANTHEM, AZ 85086-0430
(623) 505-9880
(623) 505-9880
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30511
AZ
208M00000X
Hospitalist Physician
Primary
30511
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
706484-01
—
AZ
Enumeration date
04/26/2006
Last updated
04/09/2020
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