Provider Demographics
NPI:1356104376
Name:ZARGHAMPOUR, MANOUCHEHR
Entity type:Individual
Prefix:
First Name:MANOUCHEHR
Middle Name:
Last Name:ZARGHAMPOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5333 W DUBLIN CT
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1905
Mailing Address - Country:US
Mailing Address - Phone:602-363-1681
Mailing Address - Fax:
Practice Address - Street 1:5333 W DUBLIN CT
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-1905
Practice Address - Country:US
Practice Address - Phone:602-363-1681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No342000000XTransportation ServicesTransportation Network Company
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347B00000XTransportation ServicesBus
No347E00000XTransportation ServicesTransportation Broker