Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0401X | Internist - Addiction Medicine | A85105 | CA |
NPI | 1427154038 |
---|---|
Provider Name | Dr. Daryoush Jamal |
First Address | Pasadena, CA 91107-4321 |
Second Address | Pasadena, CA 91107-4321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 18/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A851050 | (05) | CA |