Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 32432 | CA |
NPI | 1154454957 |
---|---|
Provider Name | Dr. Parviz Azar-Mehr |
First Address | Los Angeles, CA 90024-3906 |
Second Address | Los Angeles, CA 90024-3906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2007 |
Last Update Date | 08/07/2007 |