Provider Demographics
NPI:1144498692
Name:CHLOE OBSTETRICS & GYNECOLOGY, P.L.L.C.
Entity type:Organization
Organization Name:CHLOE OBSTETRICS & GYNECOLOGY, P.L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORTON-PRADHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-234-1300
Mailing Address - Street 1:500 W THOMAS RD
Mailing Address - Street 2:SUITE 670
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4224
Mailing Address - Country:US
Mailing Address - Phone:602-234-1300
Mailing Address - Fax:602-234-0202
Practice Address - Street 1:500 W. THOMAS RD
Practice Address - Street 2:SUITE 670
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4224
Practice Address - Country:US
Practice Address - Phone:602-234-1300
Practice Address - Fax:602-234-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32650207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ108384Medicare UPIN