Individual
MOHAMED NOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4734 E EDISON ST, TUCSON, AZ 85712-2721
(520) 312-9436
Mailing address
4734 E EDISON ST, TUCSON, AZ 85712-2721
(520) 312-9436
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL12794H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205088
DES ARIZONA AHCCCS
AZ
Enumeration date
10/26/2023
Last updated
03/17/2025
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