Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 20A11746 | CA |
Y | 2080P0210X | Pediatric Nephrologist | 20A11746 | CA |
NPI | 1801082003 |
---|---|
Provider Name | Dr. Noureddin Dean Nourbakhsh |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-2746 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2007 |
Last Update Date | 04/05/2017 |