Provider Demographics
NPI:1649581075
Name:AZARBEHI, NIMA (DO)
Entity Type:Individual
Prefix:DR
First Name:NIMA
Middle Name:
Last Name:AZARBEHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 E OSBORN RD STE 4
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7146
Mailing Address - Country:US
Mailing Address - Phone:480-510-8401
Mailing Address - Fax:480-378-8124
Practice Address - Street 1:1641 E OSBORN RD STE 4
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7146
Practice Address - Country:US
Practice Address - Phone:480-630-2886
Practice Address - Fax:480-378-8124
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS19719202K00000X, 207Q00000X
AZ007890202K00000X, 207Q00000X
ORDO161777207Q00000X
WY9061A208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice