Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | A100769 | CA |
NPI | 1225223324 |
---|---|
Provider Name | Avinash Islur |
First Address | Modesto, CA 95356-9262 |
Second Address | San Francisco, CA 94114-1010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2007 |
Last Update Date | 11/09/2007 |