Basic Information
| Provider Information | |||||||||
| NPI: | 1568729374 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ISFAHANI | ||||||||
| FirstName: | FIROOZEH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | Z ISFAHANI | ||||||||
| OtherFirstName: | KHADIJEH | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5555 W. THUNDERBIRD | ||||||||
| Address2: | BANNER THUNDERBIRD MEDICAL CENTER | ||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028652627 | ||||||||
| FaxNumber: | 6028652632 | ||||||||
| Practice Location | |||||||||
| Address1: | 5555 W. THUNDERBIRD | ||||||||
| Address2: | BANNER THUNDERBIRD MEDICAL CENTER | ||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6028652627 | ||||||||
| FaxNumber: | 6028652631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/18/2012 | ||||||||
| LastUpdateDate: | 01/08/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 50370 | AZ | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.