Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 45449 | CA |
NPI | 1083829188 |
---|---|
Provider Name | Dr. Nazanin Daneshmand |
First Address | Long Beach, CA 90807-2614 |
Second Address | Long Beach, CA 90807-2614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 08/07/2007 |