Healthcare Provider Details

I. General information

NPI: 1396369591
Provider Name (Legal Business Name): NAVID FALLAHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 N CRAYCROFT RD STE 100
TUCSON AZ
85712-2254
US

IV. Provider business mailing address

2625 N CRAYCROFT RD STE 100
TUCSON AZ
85712-2254
US

V. Phone/Fax

Practice location:
  • Phone: 520-420-2870
  • Fax: 520-762-4888
Mailing address:
  • Phone: 520-420-2870
  • Fax: 520-762-4888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number0116034407
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: