Organization
TATUM TECHNICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MOSHIRI (MANAGER)
(424) 322-0980
Entity
Organization
Contact information
Practice address
4045 E BELL RD STE 147, PHOENIX, AZ 85032-2239
(602) 795-0207
Mailing address
10810 N. TATUM BLVD STE 102-302, PHOENIX, AZ 85028
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
04/23/2020
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