Provider Demographics
NPI:1447780093
Name:BOURIKIAN, SEDA (MD)
Entity Type:Individual
Prefix:DR
First Name:SEDA
Middle Name:
Last Name:BOURIKIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 N LA CHOLLA BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3574
Mailing Address - Country:US
Mailing Address - Phone:520-797-6881
Mailing Address - Fax:520-219-4926
Practice Address - Street 1:6130 N LA CHOLLA BLVD STE 210
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3574
Practice Address - Country:US
Practice Address - Phone:520-797-6881
Practice Address - Fax:520-219-4926
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR76389208600000X
AZ66246208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery