Khezrian, Mohammad Ali

Khezrian, Mohammad Ali is an individual health care provider with primary practice located at 2302 N 75Th Ave , Phoenix AZ 85035-1216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Khezrian, Mohammad Ali can be contacted via phone (623) 849-7500.

Contact Information

Primary practice address
2302 N 75Th Ave Phoenix AZ 85035-1216
Phone: (623) 849-7500
Fax: (623) 849-7588
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X 37112 Arizona

Profile Details

NPI number 1922176239
LBN Legal business name Khezrian, Mohammad Ali
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2006
Last updated Apr 10th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922176239 NPPES
Arizona MEDICAID 226724

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