Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 203671 | NY |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A82220 | CA |
NPI | 1649237884 |
---|---|
Provider Name | Dr. Abbas Kashani |
First Address | Manteca, CA 95336-4960 |
Second Address | Manteca, CA 95336-4960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 17/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
264114805 | TAX ID (01) | CA |