Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 62826 | CA |
NPI | 1003240680 |
---|---|
Provider Name | Dr. Pegah Naji |
First Address | Mission Viejo, CA 92692-1643 |
Second Address | Mission Viejo, CA 92692-1643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2013 |
Last Update Date | 08/02/2022 |