Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A055727 | CA |
NPI | 1073520920 |
---|---|
Provider Name | Behzad Emad |
First Address | Los Angeles, CA 90049 |
Second Address | Los Angeles, CA 90036-5810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 07/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A557270 | (05) | CA |
G69028 | (02) |