Individual
GOLNAZ VAHDANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6622 N 91ST AVE STE 200, GLENDALE, AZ 85305-2569
(623) 547-4668
(623) 535-7869
Mailing address
3333 E CAMELBACK RD STE 180, PHOENIX, AZ 85018-2396
(602) 997-0484
(602) 943-1453
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
63698
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
095882
—
AZ
01
—
GV3232267556
MEDICAID
CA
05
—
GV3232267556
—
CA
Enumeration date
04/01/2016
Last updated
08/31/2021
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