Provider Demographics
NPI:1154398337
Name:TALLE, ARMAN (MD)
Entity type:Individual
Prefix:
First Name:ARMAN
Middle Name:
Last Name:TALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6402 E SUPERSTITION SPRINGS BLVD STE 224
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4394
Mailing Address - Country:US
Mailing Address - Phone:480-635-8100
Mailing Address - Fax:480-461-4261
Practice Address - Street 1:6750 E BAYWOOD AVE
Practice Address - Street 2:301
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-1749
Practice Address - Country:US
Practice Address - Phone:480-635-8100
Practice Address - Fax:480-461-4261
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29381207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ060064156OtherRAIL ROAD MEDICARE
AZ570946Medicaid
AZ570946Medicaid
AZZ65966Medicare PIN
AZZ148441Medicare PIN