Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 9436 | AZ |
NPI | 1013099738 |
---|---|
Provider Name | Dr. Dilip K Bobra |
First Address | Tempe, AZ 85284-3515 |
Second Address | Tempe, AZ 85282-7507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 27/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C99168 | (02) | AZ |