Healthcare Provider Details

I. General information

NPI: 1457709149
Provider Name (Legal Business Name): SHIRIN NAFISI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2016
Last Update Date: 10/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 E THOMPSON PEAK PKWY
SCOTTSDALE AZ
85255-4109
US

IV. Provider business mailing address

9225 N 3RD ST STE 300
PHOENIX AZ
85020-2466
US

V. Phone/Fax

Practice location:
  • Phone: 602-445-0751
  • Fax: 602-424-8128
Mailing address:
  • Phone: 602-445-0751
  • Fax: 602-424-8128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number58041
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number58041
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: