Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 41331 | CA |
N | 1223X0400X | Orthodontists | S3-200 | NV |
NPI | 1023108735 |
---|---|
Provider Name | Farshad A. Zaghi |
First Address | Colton, CA 92324-3918 |
Second Address | Colton, CA 92324-3918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 21/03/2018 |