Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | C50561 | CA |
NPI | 1033264999 |
---|---|
Provider Name | Gulnar Poorsattar |
First Address | Camarillo, CA 93012-5901 |
Second Address | Camarillo, CA 93012-5901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 30/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00C505610 | (05) | CA |
260051440 | TAX ID # (01) | CA |