Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 32362 | CA |
NPI | 1386991396 |
---|---|
Provider Name | Dr. Kyle Kamran Jahangiri |
First Address | Union City, CA 94587-3001 |
Second Address | Union City, CA 94587-3001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2012 |
Last Update Date | 08/08/2012 |