Individual
TARIG ELKHALIFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2020 E BROADWAY RD APT 131, TEMPE, AZ 85282-1757
(602) 373-4960
Mailing address
2020 E BROADWAY RD APT 131, TEMPE, AZ 85282-1757
(602) 373-4960
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
D05323194
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
723749
NON-EMERGENCY MEDICAL TRANSPORTATION
AZ
Enumeration date
09/30/2014
Last updated
09/30/2014
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