Organization
ISLAND DREAM DEVLOPMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARHOUD KHOSRAVI DO (MEDICAL DIRECTOR)
(515) 338-0095
Entity
Organization
Contact information
Practice address
10339 N SCOTTSDALE RD, SCOTTSDALE, AZ 85253-1426
(515) 338-0095
Mailing address
15160 N HAYDEN RD, SCOTTSDALE, AZ 85260-2587
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/10/2021
Last updated
12/10/2021
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