MEDICARE: DR. SOOFIA RUBBANI MD

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	207W00000X	Ophthalmology Physician	43494	AZ
2	207WX0200X	Ophthalmic Plastic and Reconstructive Surgery Physician	43494	AZ
3	208200000X	Plastic Surgery Physician	43494	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699825885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOOFIA RUBBANI MD

Provider Business Mailing Address
First Line	:	1230 W INA RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-3156
Country	:	US
Telephone Number	:	520-389-8080
Fax Number	:	520-639-6531

Provider Business Practice Location Address
First Line	:	1230 W INA RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-3156
Country	:	US
Telephone Number	:	520-389-8080
Fax Number	:	520-639-6531

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	03/26/2021

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Directions to “ DR. SOOFIA RUBBANI MD” Practice Location

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