Basic Information
| Provider Information | |||||||||
| NPI: | 1366822801 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NATARAJAN | ||||||||
| FirstName: | BALAJI | ||||||||
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| Credential: | M.B.B.S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3815 E BELL RD STE 2200 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850322139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6026333848 | ||||||||
| FaxNumber: | 6026333841 | ||||||||
| Practice Location | |||||||||
| Address1: | 2800 E AJO WAY | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857136204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5208744276 | ||||||||
| FaxNumber: | 5208744510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2015 | ||||||||
| LastUpdateDate: | 08/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | R75123 | AZ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0011X | 64400 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.