Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A108751 | CA |
NPI | 1063629079 |
---|---|
Provider Name | Dr. Cyrus Sharuz Sedaghat |
First Address | Irvine, CA 92614-8579 |
Second Address | Huntington Beach, CA 92648-6021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 20/07/2012 |