Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 6198 | NV |
N | 213EG0000X | General Practice | 6198 | NV |
Y | 1223X0400X | Orthodontists | 64413 | CA |
NPI | 1063784239 |
---|---|
Provider Name | Dr. Simon Yashari |
First Address | Bakersfield, CA 93311-1167 |
Second Address | Ridgecrest, CA 93555-3157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2012 |
Last Update Date | 04/08/2015 |