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General NPI Number Information
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NPI Number | 1235115130
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Entity Type | Organization
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Legal Business Name | MOHAMMADI MEDICAL PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2039 S MILL AVE
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City | TEMPE
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State | AZ
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Zip | 85282-2137
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Country | US
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Telephone | 480-968-2990
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Fax |
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Provider Business Mailing Address
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Address Line | 9026 N 83RD ST
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-1817
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Country | US
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Telephone | 480-323-0838
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Fax | 480-588-6212
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAEID MOHAMMADI
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Credential | M.D.
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Telephone | 480-968-2990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 32760
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License Number State | AZ
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