=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679527683
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BELLA WOMEN'S CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 650 W MARYLAND AVE SUITE1
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85013-1399
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-240-2401
-----------------------------------------------------
Fax | 602-240-5540
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 650 W MARYLAND AVE SUITE1
-----------------------------------------------------
City | PHOENIX
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85013-1399
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 602-240-2401
-----------------------------------------------------
Fax | 602-240-5540
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MANI TEHRANCHI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 602-240-2401
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------