Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 171381 | CA |
NPI | 1114378650 |
---|---|
Provider Name | Dr. Nancy Jayne Moontasri |
First Address | Sacramento, CA 95817 |
Second Address | Paterson, NJ 07503-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2016 |
Last Update Date | 23/07/2021 |