Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | DC23480 | CA |
NPI | 1093014078 |
---|---|
Provider Name | Jemiss Nazar |
First Address | North Hollywood, CA 91606-3184 |
Second Address | North Hollywood, CA 91606-3184 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2011 |
Last Update Date | 16/03/2011 |