Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 38390 | CA |
NPI | 1063593390 |
---|---|
Provider Name | Dr. Alexa A Alborzi |
First Address | San Mateo, CA 94401-2672 |
Second Address | San Mateo, CA 94401-2672 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |