Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | 0101243728 | VA |
N | 207YS0123X | Facial Plastic Surgeon | D0064798 | MD |
Y | 207YS0123X | Facial Plastic Surgeon | MD036224 | DC |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MD036224 | DC |
NPI | 1255388799 |
---|---|
Provider Name | Dr. Houtan Chaboki |
First Address | Washington, DC 20037-1468 |
Second Address | Washington, DC 20037-1468 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 17/12/2019 |