Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A43718 | CA |
NPI | 1073533345 |
---|---|
Provider Name | Hossein Habibi |
First Address | San Jose, CA 95116-1909 |
Second Address | San Jose, CA 95116-1909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 16/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A437180 | (02) | CA |