Healthcare Provider Details

I. General information

NPI: 1851966246
Provider Name (Legal Business Name): SOHA GHANIAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 E GRANT RD
TUCSON AZ
85712-2805
US

IV. Provider business mailing address

7165 N PIMA CANYON DR
TUCSON AZ
85718-1407
US

V. Phone/Fax

Practice location:
  • Phone: 480-338-9336
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number66679
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: