Provider Demographics
NPI:1750307302
Name:HOUSHANG SEMINO MDPC
Entity Type:Organization
Organization Name:HOUSHANG SEMINO MDPC
Other - Org Name:HOUSHANG SEMINO MDPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOUSHANG
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-390-2496
Mailing Address - Street 1:17215 N 72ND DR
Mailing Address - Street 2:BUILDING D 140A
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8558
Mailing Address - Country:US
Mailing Address - Phone:623-487-9630
Mailing Address - Fax:
Practice Address - Street 1:17215 N 72ND DR
Practice Address - Street 2:BUILDING D 140A
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8558
Practice Address - Country:US
Practice Address - Phone:623-487-9630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ107512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD00293Medicare UPIN
AZG44896Medicare UPIN