=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184575946
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SANOVA PODIATRY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2026
-----------------------------------------------------
Last Update Date | 02/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5983 E GRANT RD STE 101
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85712-2366
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-201-6990
-----------------------------------------------------
Fax | 520-363-6153
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7959 N THORNYDALE RD # 89520
-----------------------------------------------------
City | TUCSON
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85741-1443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | KIYAN RAD
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 520-201-6990
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------