Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A144007 | CA |
N | 207ND0900X | Dermatopathologist | A144007 | CA |
N | 2086X0206X | Surgical Oncologist | A144007 | CA |
NPI | 1447679865 |
---|---|
Provider Name | Dr. Teo Soleymani |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Redondo Beach, CA 90277-3036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2014 |
Last Update Date | 12/10/2020 |