Provider Demographics
NPI:1679863427
Name:SANA, NIMA (DPM)
Entity Type:Individual
Prefix:DR
First Name:NIMA
Middle Name:
Last Name:SANA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 N SCOTTSDALE RD STE 270
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5270
Mailing Address - Country:US
Mailing Address - Phone:480-253-9996
Mailing Address - Fax:844-733-9353
Practice Address - Street 1:11000 N SCOTTSDALE RD STE 270
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5270
Practice Address - Country:US
Practice Address - Phone:480-253-9996
Practice Address - Fax:844-733-9353
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0795213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ7767953OtherAETNA
AZ937319Medicaid
AZ6905666OtherCIGNA
AZ7767953OtherAETNA