Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | ND-179 | CA |
NPI | 1053527556 |
---|---|
Provider Name | Dr. Shiva Pourazima |
First Address | Campbell, CA 95008-5716 |
Second Address | Campbell, CA 95008-3020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |