Healthcare Provider Details

I. General information

NPI: 1225599574
Provider Name (Legal Business Name): SOFIA LAKHDAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SOFIA LAKHDAR MD

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5777 E MAYO BLVD
PHOENIX AZ
85054-4502
US

IV. Provider business mailing address

5777 E MAYO BLVD
PHOENIX AZ
85054-4502
US

V. Phone/Fax

Practice location:
  • Phone: 480-342-2000
  • Fax:
Mailing address:
  • Phone: 480-342-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number75737
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: