Provider Demographics
NPI:1083893796
Name:AFTAHI, INC
Entity Type:Organization
Organization Name:AFTAHI, INC
Other - Org Name:ESTRELLA GASTROENTEROLOGY GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:AFTAHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-935-4056
Mailing Address - Street 1:13657 W MCDOWELL RD STE 204
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-2603
Mailing Address - Country:US
Mailing Address - Phone:623-935-4056
Mailing Address - Fax:623-935-2018
Practice Address - Street 1:13657 W MCDOWELL RD STE 204
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-2603
Practice Address - Country:US
Practice Address - Phone:623-935-4056
Practice Address - Fax:623-935-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ80254Medicare PIN