Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | A33403 | CA |
NPI | 1144301748 |
---|---|
Provider Name | Farid Afra |
First Address | Beverly Hills, CA 90210-1904 |
Second Address | Beverly Hills, CA 90210-1904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |