Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A130140 | CA |
NPI | 1023363223 |
---|---|
Provider Name | Dr. Mitra Nejad |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-2004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2012 |
Last Update Date | 09/08/2018 |