Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 59508 | CA |
NPI | 1063725638 |
---|---|
Provider Name | Dr. Pejman Parsa |
First Address | Los Angeles, CA 90024-4005 |
Second Address | Los Angeles, CA 90024-4005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2010 |
Last Update Date | 17/03/2018 |