Provider Demographics
NPI:1457885360
Name:BITA NOORANBAKHT MD LLC
Entity Type:Organization
Organization Name:BITA NOORANBAKHT MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOORANBAKHT
Authorized Official - Suffix:
Authorized Official - Credentials:M,D,
Authorized Official - Phone:480-718-5986
Mailing Address - Street 1:3225 N 75TH ST
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6909
Mailing Address - Country:US
Mailing Address - Phone:480-718-5986
Mailing Address - Fax:480-947-2494
Practice Address - Street 1:3225 N 75TH ST
Practice Address - Street 2:SUITE 125
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6909
Practice Address - Country:US
Practice Address - Phone:480-718-5986
Practice Address - Fax:480-947-2494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30670310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility