Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | A83156 | CA |
NPI | 1457422065 |
---|---|
Provider Name | Dr. Jahangir Sharifi |
First Address | Los Angeles, CA 90033-2464 |
Second Address | Los Angeles, CA 90033-2464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 26/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I37159 | (02) | CA |