Provider Demographics
NPI:1285947861
Name:SAZMAND, TAKESH (DO)
Entity type:Individual
Prefix:DR
First Name:TAKESH
Middle Name:
Last Name:SAZMAND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 E CAMELBACK RD STE 700
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-2400
Mailing Address - Country:US
Mailing Address - Phone:480-809-4829
Mailing Address - Fax:623-322-6147
Practice Address - Street 1:9582 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761
Practice Address - Country:US
Practice Address - Phone:407-363-6700
Practice Address - Fax:407-865-6012
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS142582085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLV115184OtherFL MEDICARE
AZ2085R0202XOtherTAXONOMY
AZ210314Medicaid
FLOS14258OtherFL MEDICAL LICENSE
AZ007086OtherAZ MEDICAL LICENSE