Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 2005012339 | MO |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A115132 | CA |
NPI | 1306930821 |
---|---|
Provider Name | Dr. Arash Moradzadeh |
First Address | Beverly Hills, CA 90211-1847 |
Second Address | Beverly Hills, CA 90212-2247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 03/01/2017 |