Healthcare Provider Details

I. General information

NPI: 1386795771
Provider Name (Legal Business Name): DESERT RUN MULTISPECIALTY PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 N 19TH AVE SUITE 3
PHOENIX AZ
85015-4602
US

IV. Provider business mailing address

4350 N 19TH AVE SUITE 3
PHOENIX AZ
85015-4602
US

V. Phone/Fax

Practice location:
  • Phone: 602-279-4975
  • Fax: 602-279-1108
Mailing address:
  • Phone: 602-279-4975
  • Fax: 602-279-1108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. HAMID SATTAR
Title or Position: OWNER
Credential: M.D.
Phone: 602-279-4975