Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 57643 | CA |
NPI | 1144476581 |
---|---|
Provider Name | Dr. Royeen Nesari |
First Address | Union City, CA 94587-1905 |
Second Address | San Francisco, CA 94110-2468 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2008 |
Last Update Date | 07/06/2010 |