Provider Demographics
NPI:1881036531
Name:MOSLEM, MOBEEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MOBEEN
Middle Name:
Last Name:MOSLEM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10620 E BARCLAY PARK LOOP
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-1727
Mailing Address - Country:US
Mailing Address - Phone:520-289-6336
Mailing Address - Fax:
Practice Address - Street 1:1880 E IRVINGTON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-1754
Practice Address - Country:US
Practice Address - Phone:520-889-3902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS019876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist