Individual
PURNA CHETTRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6320B W UNION HILLS DR, STE B2300, GLENDALE, AZ 85308-7201
(623) 561-9113
(623) 561-6148
Mailing address
2500 W UTOPIA RD, STE. 100, PHOENIX, AZ 85027-4171
(602) 214-6148
(602) 214-6149
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41585
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174514756
YOUR FAMILY PHYSICIAN
AZ
01
—
Z22506
MEDICARE GROUP PIN
AZ
Enumeration date
06/24/2008
Last updated
09/24/2013
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