Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 33383 | CA |
N | 111NN1001X | Nutrition | 33383 | CA |
NPI | 1821450800 |
---|---|
Provider Name | Dr. Natasha Fallahi |
First Address | Berkeley, CA 94705-1131 |
Second Address | Berkeley, CA 94705-1131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2016 |
Last Update Date | 28/03/2016 |