Provider Demographics
NPI:1043424633
Name:MASHAQI, SAIF (MD)
Entity Type:Individual
Prefix:
First Name:SAIF
Middle Name:
Last Name:MASHAQI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 N. CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:TUSCON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719
Mailing Address - Country:US
Mailing Address - Phone:520-694-4647
Mailing Address - Fax:520-694-2515
Practice Address - Street 1:1625 N. CAMPBELL AVE
Practice Address - Street 2:CENTER FOR SLEEP DISORDERS
Practice Address - City:TUSCON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:520-694-4647
Practice Address - Fax:520-694-2515
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN61314207RS0012X
390200000X
ND12714207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
58593OtherMEDICAL LICENSE#
AZ586157Medicaid