Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | A146795 | CA |
NPI | 1114153509 |
---|---|
Provider Name | Dr. Shahrouz Zarrabi |
First Address | Newport Beach, CA 92657-0131 |
Second Address | Corona Del Mar, CA 92625-2258 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2009 |
Last Update Date | 17/09/2019 |