Basic Information
| Provider Information | |||||||||
| NPI: | 1689739054 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TASLIMI | ||||||||
| FirstName: | MASOUD | ||||||||
| MiddleName: | MARK | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 570 HENRY COWELL DR | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950601481 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6502692539 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 880 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381033409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9015153500 | ||||||||
| FaxNumber: | 9015153509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2006 | ||||||||
| LastUpdateDate: | 01/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 25177 | WI | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VM0101X | 14756 | TN | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine | 207VM0101X | 25177 | WI | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
No ID Information.