Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 63267 | CA |
NPI | 1073909115 |
---|---|
Provider Name | Dr. Parisa Shahi |
First Address | San Jose, CA 95126-2203 |
Second Address | Daly City, CA 94015-2630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2015 |
Last Update Date | 14/12/2021 |