| Doctor Name: | VISHAL ATAISH GANESH |
| NPI Number: | 1629289517 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 44706 |
| Business Practice Address: | 10450 W Mcdowell Rd Ste 102 Avondale, AZ - 853924901 |
| Business Phone Number: | 6238467614 |
| Business Fax Number: | 6238460993 |
| Mailing Address: | P.o. Box 29870, PHOENIX |
| State: | AZ |
| Postal Code: | 85038 |
| Phone Number: | 6027723805 |
| Fax Number: | 6027723801 |
| NPI Enumeration Date: | 05/24/2007 |
| NPI Last Update Date: | 10/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 44706 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |