Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 2005-0527 | NM |
N | 207YS0123X | Facial Plastic Surgeon | 36688 | AZ |
NPI | 1114948353 |
---|---|
Provider Name | Farhan Taghizadeh |
First Address | Phoenix, AZ 85016-5189 |
Second Address | Phoenix, AZ 85016-5189 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 21/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
207YS0123X | (05) | NM |
973827 | (05) | AZ |