Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | A55703 | CA |
NPI | 1457404840 |
---|---|
Provider Name | Dr. Farnaz Gaminchi |
First Address | West Hills, CA 91307 |
Second Address | West Hills, CA 91307-1468 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2007 |
Last Update Date | 05/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G69027 | (02) | CA |