Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 63815 | MN |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | A122776 | CA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MT212625 | PA |
NPI | 1346536703 |
---|---|
Provider Name | Amirhossein Misaghi |
First Address | Rochester, MN 55905-0001 |
Second Address | Orange, CA 92868-3856 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 07/05/2019 |