Provider Demographics
NPI:1770584054
Name:RASHIDI, BABAK (MD)
Entity type:Individual
Prefix:
First Name:BABAK
Middle Name:
Last Name:RASHIDI
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 1:4383 N 75TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3583
Mailing Address - Country:US
Mailing Address - Phone:480-513-2727
Mailing Address - Fax:480-513-2729
Practice Address - Street 1:4383 N 75TH ST STE 103
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3583
Practice Address - Country:US
Practice Address - Phone:480-513-2727
Practice Address - Fax:480-513-2729
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ33980208D00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ947377Medicaid
AZZ105676Medicare PIN