Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A114252 | CA |
NPI | 1043448533 |
---|---|
Provider Name | Dr. Hossein Mirheydar |
First Address | Sacramento, CA 95827-2539 |
Second Address | Roseville, CA 95661-3087 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2009 |
Last Update Date | 29/11/2021 |