Basic Information
| Provider Information | |||||||||
| NPI: | 1376730234 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOHSEN SHEINI | ||||||||
| FirstName: | NAKISA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 4001 E SUNRISE DR | ||||||||
| Address2: | SUITE 161 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857184333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5202325280 | ||||||||
| FaxNumber: | 5202325299 | ||||||||
| Practice Location | |||||||||
| Address1: | 4001 E SUNRISE DR | ||||||||
| Address2: | SUITE 161 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857184333 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5202325280 | ||||||||
| FaxNumber: | 5202325299 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2007 | ||||||||
| LastUpdateDate: | 01/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 01/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 37567 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 257800 | 05 | AZ | MEDICAID | P00431754 | 01 | AZ | RAILROAD MEDICARE | OTHER |