Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | A90211 | CA |
NPI | 1144215849 |
---|---|
Provider Name | Dr. Peyman Soliemanzadeh |
First Address | Los Angeles, CA 90069-3701 |
Second Address | Los Angeles, CA 90069-3701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 04/10/2007 |