Healthcare Provider Details

I. General information

NPI: 1548469992
Provider Name (Legal Business Name): HENGAMEH RASTEGAR-MURPHY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 E GRANT RD
TUCSON AZ
85712-2805
US

IV. Provider business mailing address

PO BOX 31235
TUCSON AZ
85751-1235
US

V. Phone/Fax

Practice location:
  • Phone: 520-324-5461
  • Fax: 520-324-1406
Mailing address:
  • Phone: 520-324-5461
  • Fax: 520-324-1406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35969
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: