Individual
DR. BASIM TALIANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4625 E RAY RD, PHOENIX, AZ 85044-6229
(602) 760-0890
Mailing address
16122 108 ST NW, EDMONTON, AB T5X4Z-7
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT-002399
AZ
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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