Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP0504X | Public Medicine | E4331 | CA |
N | 111NR0200X | Radiology | E4331 | CA |
N | 213ER0200X | Radiology | E4331 | CA |
N | 2081S0010X | Sports Medicine | E4331 | CA |
N | 213ES0000X | Sports Medicine | E4331 | CA |
Y | 213ES0103X | Foot & Ankle Surgery | E4331 | CA |
N | 213ES0131X | Foot Surgery | E4331 | CA |
NPI | 1265489546 |
---|---|
Provider Name | Kamran Jamshidinia |
First Address | Beverly Hills, CA 90209-2600 |
Second Address | Los Angeles, CA 90067-2001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 19/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U86783 | (02) | CA |