Provider Demographics
NPI:1366650186
Name:DEYHIMPANAH, AFSHIN (MD)
Entity Type:Individual
Prefix:
First Name:AFSHIN
Middle Name:
Last Name:DEYHIMPANAH
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 1:2040 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE # 1, PMB #178
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-7075
Mailing Address - Country:US
Mailing Address - Phone:480-728-3000
Mailing Address - Fax:
Practice Address - Street 1:2040 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE # 1, PMB #178
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-7075
Practice Address - Country:US
Practice Address - Phone:480-728-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6175208M00000X
NY255633208M00000X
282N00000X
AZ41085208M00000X
CAA111794208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No282N00000XHospitalsGeneral Acute Care Hospital