Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 60857316 | WA |
N | 1223G0001X | General Practice | 60857316 | WA |
N | 213EG0000X | General Practice | 60857316 | WA |
NPI | 1124509468 |
---|---|
Provider Name | Dr. Hadjir Haghparast Hassas |
First Address | Rancho Palos Verdes, CA 90275 |
Second Address | Gig Harbor, WA 98335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2018 |
Last Update Date | 24/08/2018 |