Healthcare Provider Details

I. General information

NPI: 1699142497
Provider Name (Legal Business Name): TORABI PLASTIC SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2015
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10910 N TATUM BLVD STE B100
PHOENIX AZ
85028-3080
US

IV. Provider business mailing address

10910 N TATUM BLVD STE B-100
PHOENIX AZ
85028-3080
US

V. Phone/Fax

Practice location:
  • Phone: 480-291-6895
  • Fax:
Mailing address:
  • Phone: 480-291-6895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROZBEH TORABI
Title or Position: OWNER
Credential: MD
Phone: 480-291-6895