Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | A122478 | CA |
NPI | 1558674374 |
---|---|
Provider Name | Amir E Entezari |
First Address | Fontana, CA 92335-6720 |
Second Address | Long Beach, CA 90806-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2010 |
Last Update Date | 13/12/2021 |