Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | A104346 | CA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 13044 | NV |
NPI | 1235376377 |
---|---|
Provider Name | Dr. Christopher Khorsandi |
First Address | Las Vegas, NV 89102-3654 |
Second Address | Henderson, NV 89052-5050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2009 |
Last Update Date | 20/02/2014 |