Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | A69894 | CA |
NPI | 1295768638 |
---|---|
Provider Name | Dr. Maryam Tarsa |
First Address | San Diego, CA 92193-2410 |
Second Address | San Diego, CA 92103-9000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 20/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A698940 | (05) | CA |
H64001 | (02) | CA |