Provider Demographics
NPI:1154712065
Name:ELITE PLASTIC SURGERY PLLC
Entity type:Organization
Organization Name:ELITE PLASTIC SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROZBEH
Authorized Official - Middle Name:
Authorized Official - Last Name:TORABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-837-8851
Mailing Address - Street 1:7425 E SHEA BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6411
Mailing Address - Country:US
Mailing Address - Phone:480-291-6895
Mailing Address - Fax:480-291-6899
Practice Address - Street 1:3501 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-5648
Practice Address - Country:US
Practice Address - Phone:480-513-2727
Practice Address - Fax:480-513-2729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ49766261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty