Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A48921 | CA |
NPI | 1164593802 |
---|---|
Provider Name | Dr. Daryoush Jadali |
First Address | Thousand Oaks, CA 91359-7448 |
Second Address | Thousand Oaks, CA 91360-1935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A48921 | (05) | CA |
F54206 | (02) | CA |