Individual
HOSSAIN BASIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15090 N NORTHSIGHT BLVD STE 105, SCOTTSDALE, AZ 85260-2609
(480) 550-4747
Mailing address
15090 N NORTHSIGHT BLVD STE 105, SCOTTSDALE, AZ 85260-2609
(480) 550-4747
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2817I
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D07020536
DRIVER LICENSE
AZ
Enumeration date
08/10/2018
Last updated
08/10/2018
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