Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD60611578 | WA |
Y | 208600000X | Surgeon | MD60611578 | WA |
NPI | 1013563741 |
---|---|
Provider Name | Dr. Amirali Shakouripartovi |
First Address | Playa Vista, CA 90094-2719 |
Second Address | Tacoma, WA 98402-5209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2019 |
Last Update Date | 19/08/2019 |