Healthcare Provider Details

I. General information

NPI: 1033527288
Provider Name (Legal Business Name): NEDA KOBARI GHOTBI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 07/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 N SCOTTSDALE RD
PARADISE VALLEY AZ
85253-1421
US

IV. Provider business mailing address

10010 N SCOTTSDALE RD
PARADISE VALLEY AZ
85253-1421
US

V. Phone/Fax

Practice location:
  • Phone: 480-607-5025
  • Fax: 480-607-7551
Mailing address:
  • Phone: 480-607-5025
  • Fax: 480-607-7551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14919
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59561
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: