Provider Demographics
NPI:1447260831
Name:NAJI-TALAKAR, BAHMAN (PA)
Entity type:Individual
Prefix:MR
First Name:BAHMAN
Middle Name:
Last Name:NAJI-TALAKAR
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6229
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-2510
Mailing Address - Country:US
Mailing Address - Phone:928-344-0810
Mailing Address - Fax:928-343-0491
Practice Address - Street 1:2377 S 22ND DR
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8865
Practice Address - Country:US
Practice Address - Phone:928-343-0488
Practice Address - Fax:928-782-0401
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2738363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP91488Medicare UPIN
AZ1176490001Medicare NSC