Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 5762 | NV |
N | 1223X0400X | Orthodontists | 27088 | TX |
Y | 1223X0400X | Orthodontists | 60349 | CA |
NPI | 1003056409 |
---|---|
Provider Name | Dr. Mark Mahbod Rashidi |
First Address | Oceanside, CA 92056-4522 |
Second Address | Mission Viejo, CA 92691-6708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2009 |
Last Update Date | 16/11/2018 |