MEDICARE: MR. KIANOUSH SAFARI MAHFROUJAKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)		AZ

General Provider Information

NPI Number	:	1073458006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KIANOUSH SAFARI MAHFROUJAKI

Provider Business Mailing Address
First Line	:	860 N MCQUEEN RD UNIT 1020
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85225-3998
Country	:	US
Telephone Number	:	480-470-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	860 N MCQUEEN RD UNIT 1020
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85225-3998
Country	:	US
Telephone Number	:	480-470-0000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2026
Last Update Date	:	04/23/2026

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Directions to “ MR. KIANOUSH SAFARI MAHFROUJAKI ” Practice Location

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