Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 0793 | AZ |
NPI | 1003233834 |
---|---|
Provider Name | Kaveh Panahi |
First Address | Peoria, AZ 85381-4250 |
Second Address | Peoria, AZ 85381-4250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2014 |
Last Update Date | 24/05/2020 |