Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | A117210 | CA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A117210 | CA |
NPI | 1023027695 |
---|---|
Provider Name | Dr. Arash Kermanshahi |
First Address | La Jolla, CA 92037-1027 |
Second Address | La Jolla, CA 92037-1027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 06/12/2021 |