Healthcare Provider Details

I. General information

NPI: 1316593114
Provider Name (Legal Business Name): ARYAN MODASI MD, MSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 N PIMA RD STE 280
SCOTTSDALE AZ
85258-4488
US

IV. Provider business mailing address

6815 E CAMELBACK RD APT 7020
SCOTTSDALE AZ
85251-2420
US

V. Phone/Fax

Practice location:
  • Phone: 480-245-4425
  • Fax:
Mailing address:
  • Phone: 813-449-2761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number65131
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: