Basic Information
| Provider Information | |||||||||
| NPI: | 1740427616 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MANOJ RAWAL, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1149 | ||||||||
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| City: | PEORIA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853801149 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235832073 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11124 W CALIFORNIA AVE | ||||||||
| Address2: | |||||||||
| City: | YOUNGTOWN | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853631246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6235832073 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/14/2009 | ||||||||
| LastUpdateDate: | 01/14/2009 | ||||||||
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| AuthorizedOfficialLastName: | RAWAL | ||||||||
| AuthorizedOfficialFirstName: | MANOJ | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6235832073 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 34083 | AZ | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.