Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A88805 | CA |
NPI | 1336186725 |
---|---|
Provider Name | Dr. Keyvan Zavarei |
First Address | Long Beach, CA 90806-1530 |
Second Address | Long Beach, CA 90806-1530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 24/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I30143 | (02) | CA |