Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | C52328 | CA |
NPI | 1134109390 |
---|---|
Provider Name | Dr. Mahmood Pazirandeh |
First Address | San Diego, CA 92108-4011 |
Second Address | San Diego, CA 92108-4011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2006 |
Last Update Date | 26/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DD083Y | (02) | CA |
DD083Z | (02) | CA |