Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 42411 | CA |
NPI | 1225124944 |
---|---|
Provider Name | Dr. Haroun Rostami |
First Address | Los Angeles, CA 90049 |
Second Address | Los Angeles, CA 90049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 23/07/2014 |