Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 42799 | CA |
NPI | 1053594580 |
---|---|
Provider Name | Kati Ozra Asgarifar |
First Address | Oxnard, CA 93030-5917 |
Second Address | Oxnard, CA 93030-5917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2007 |
Last Update Date | 06/12/2007 |