Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | A83949 | CA |
NPI | 1366520991 |
---|---|
Provider Name | Hootan C. Roozrokh |
First Address | Los Gatos, CA 95032-2600 |
Second Address | Los Gatos, CA 95032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 16/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A839490 | (05) | CA |
I09644 | (02) |