Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 53940 | KY |
NPI | 1053798173 |
---|---|
Provider Name | Dr. Navid Jason Pour-Ghasemi |
First Address | Los Angeles, CA 90033-1029 |
Second Address | Los Angeles, CA 90033-1029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2015 |
Last Update Date | 27/10/2020 |