Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 22271 | MA |
Y | 1223E0200X | Endodontist | 57584 | CA |
NPI | 1003063652 |
---|---|
Provider Name | Dr. Arjang Vahidnia |
First Address | Los Angeles, CA 90036-2547 |
Second Address | Los Angeles, CA 90036-2547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2008 |
Last Update Date | 23/07/2014 |