Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A99917 | CA |
NPI | 1023292851 |
---|---|
Provider Name | Dr. Pejvak Sassani |
First Address | Los Angeles, CA 90027-5814 |
Second Address | Los Angeles, CA 90027-5814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2007 |
Last Update Date | 14/10/2021 |