Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | G080322 | CA |
N | 208200000X | Surgeon | G080322 | CA |
N | 208600000X | Surgeon | G080322 | CA |
N | 2086S0122X | Plastic and Reconstructive Surgery | G80322 | CA |
NPI | 1245358969 |
---|---|
Provider Name | Dr. Mehrdad Hassid |
First Address | Beverly Hills, CA 90211 |
Second Address | Beverly Hills, CA 90211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 05/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H41638 | (02) | CA |