Basic Information
| Provider Information | |||||||||
| NPI: | 1215371125 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAINI | ||||||||
| FirstName: | SHAWNJEET | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 29025 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850389025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6233289704 | ||||||||
| FaxNumber: | 6238888570 | ||||||||
| Practice Location | |||||||||
| Address1: | 20045 N. 19TH AVENUE | ||||||||
| Address2: | BLDG 10, SUITE 3 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806262552 | ||||||||
| FaxNumber: | 4806262551 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2013 | ||||||||
| LastUpdateDate: | 09/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | R3202 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | R3202 | TX | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP2900X | 56420 | AZ | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 375725401 | 05 | TX | MEDICAID | 375725402 | 01 | TX | CSHCN | OTHER | 399166 | 05 | AZ | MEDICAID |