Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A48313 | CA |
N | 2086S0122X | Plastic and Reconstructive Surgery | A48313 | CA |
NPI | 1235203449 |
---|---|
Provider Name | Dr. Mohammad Reza Kalantari Nejad |
First Address | Encino, CA 91436-1914 |
Second Address | Encino, CA 91436-1914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 01/05/2009 |