Provider Demographics
NPI:1740367549
Name:ALSBIEI, TALAL (MD)
Entity type:Individual
Prefix:
First Name:TALAL
Middle Name:
Last Name:ALSBIEI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 N WILMOT RD STE 201
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2701
Mailing Address - Country:US
Mailing Address - Phone:520-790-1556
Mailing Address - Fax:520-620-9719
Practice Address - Street 1:603 N WILMOT RD STE 201
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2701
Practice Address - Country:US
Practice Address - Phone:520-790-1556
Practice Address - Fax:520-620-9719
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33701207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ921553Medicaid
AZZ92068Medicare PIN
I26190Medicare UPIN