Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 33300 | CA |
NPI | 1003296096 |
---|---|
Provider Name | Dr. Ahmad Naweed Kazem |
First Address | San Diego, CA 92103-2655 |
Second Address | San Diego, CA 92103-2657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2015 |
Last Update Date | 02/03/2016 |