Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | A118279 | CA |
N | 207QA0401X | Family Doctor - Addiction Medicine | A118279 | CA |
NPI | 1902125776 |
---|---|
Provider Name | Behnaz Haghighi Motlagh |
First Address | Laguna Niguel, CA 92677-3919 |
Second Address | Laguna Niguel, CA 92677-3919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2010 |
Last Update Date | 03/06/2019 |