Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E3996 | CA |
NPI | 1003984436 |
---|---|
Provider Name | Babak Alavynejad |
First Address | Beverly Hills, CA 90212-3851 |
Second Address | West Covina, CA 91790-2662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2006 |
Last Update Date | 04/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E39961 | (05) | CA |
U60239 | (02) | CA |