Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | A101245 | CA |
NPI | 1043497860 |
---|---|
Provider Name | Dr. Hamid Tavakoli Zadeh |
First Address | Imperial, CA 92251-9599 |
Second Address | Imperial, CA 92251-9599 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2008 |
Last Update Date | 13/12/2018 |