Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | A85870A | CA |
NPI | 1093726002 |
---|---|
Provider Name | Arian S Mowlavi |
First Address | Laguna Beach, CA 92651 |
Second Address | Laguna Beach, CA 92651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 11/05/2015 |