Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 42966 | CA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | A97353 | CA |
NPI | 1215035696 |
---|---|
Provider Name | Dr. Arsalan Ahani |
First Address | San Mateo, CA 94401-2824 |
Second Address | San Mateo, CA 94401-2824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 12/02/2008 |