Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 45774 | CA |
NPI | 1043366487 |
---|---|
Provider Name | Cyrous Sheikh |
First Address | Carlsbad, CA 92009-3096 |
Second Address | Carlsbad, CA 92009-3096 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 06/12/2011 |