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NPI Code Detail

MEDICARE: APS IOM PROFESSIONAL LLC

MEDICARE: APS IOM PROFESSIONAL LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician

General Provider Information

NPI Number : 1447801881
Entity Type Code : Organization
Provider Name (Legal Business Name) : APS IOM PROFESSIONAL LLC
Provider Business Mailing Address
First Line : 2250 E GERMANN RD STE 8
Second Line :
City : CHANDLER
State : AZ
Zip : 85286-1575
Country : US
Telephone Number : 480-926-7800
Fax Number : 480-926-2260
Provider Business Practice Location Address
First Line : 1450 W GUADALUPE RD STE 124
Second Line :
City : GILBERT
State : AZ
Zip : 85233-3056
Country : US
Telephone Number : 480-307-8258
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RADMAN RAHIMINEJAD
Credential :
Telephone Number : 480-926-7800
Provider Enumeration Date : 09/26/2019
Last Update Date : 08/19/2021

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Directions to “APS IOM PROFESSIONAL LLC ” Practice Location

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