Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 57053 | CA |
NPI | 1023116845 |
---|---|
Provider Name | Dr. Nader Ehsani |
First Address | San Diego, CA 92123-3357 |
Second Address | San Diego, CA 92123-3357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 03/06/2014 |