MEDICARE: ROADRUNNER MEDICAL OPERATIONS AZ LLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1477412419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROADRUNNER MEDICAL OPERATIONS AZ LLC

Provider Business Mailing Address
First Line	:	3961 E CHANDLER BLVD STE 111-244
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-0303
Country	:	US
Telephone Number	:	908-748-4471
Fax Number	:

Provider Business Practice Location Address
First Line	:	16515 S 40TH ST STE 135
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85048-0560
Country	:	US
Telephone Number	:	908-748-4472
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KAMRAN TASHAROFI
Credential	:	MD
Telephone Number	:	908-748-4471

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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