Provider Demographics
NPI:1053575167
Name:A SULTAN LALANI M D LTD
Entity type:Organization
Organization Name:A SULTAN LALANI M D LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTOLARYNGOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:SULTAN
Authorized Official - Last Name:LALANI
Authorized Official - Suffix:I
Authorized Official - Credentials:MD
Authorized Official - Phone:928-783-7811
Mailing Address - Street 1:2175 S AVENUE A STE B
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8458
Mailing Address - Country:US
Mailing Address - Phone:928-783-7811
Mailing Address - Fax:928-783-0036
Practice Address - Street 1:2175 S AVENUE A STE B
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8458
Practice Address - Country:US
Practice Address - Phone:928-783-7811
Practice Address - Fax:928-783-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMD10298207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & NeckGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ040001213OtherRRMC
AZ1063440816OtherPROVIDERS NPI
AZ=========OtherTAX IDENTIFICATION
AZ=========OtherTAX IDENTIFICATION
AZZ214645698Medicare PIN