Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 01049734A | IN |
Y | 207RI0011X | Interventional Cardiology | 01049734A | IN |
NPI | 1093717282 |
---|---|
Provider Name | Dr. Farid Jalinous |
First Address | Goshen, IN 46526-4853 |
Second Address | Goshen, IN 46526 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 12/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200129720 | (05) | IN |
200197420A | (05) | IN |
G10076 | (02) | IN |