Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 42008 | CA |
NPI | 1114037470 |
---|---|
Provider Name | Dr. Adel Rasmy Tawfilis |
First Address | San Diego, CA 92130-3058 |
Second Address | San Diego, CA 92130-3058 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U91377 | (02) |