Provider Demographics
NPI:1649717570
Name:SOOMRO, ABDUL GHAFFAR
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:GHAFFAR
Last Name:SOOMRO
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 1:1920 W SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85621-3850
Mailing Address - Country:US
Mailing Address - Phone:928-707-4430
Mailing Address - Fax:
Practice Address - Street 1:1920 W SUNSET DR
Practice Address - Street 2:
Practice Address - City:NOGALES
Practice Address - State:AZ
Practice Address - Zip Code:85621-3850
Practice Address - Country:US
Practice Address - Phone:928-707-4430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant