Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 20A9343 | CA |
NPI | 1053490003 |
---|---|
Provider Name | Kevin Sohi Sadati |
First Address | San Juan Capistrano, CA 92675-1890 |
Second Address | Newport Beach, CA 92660 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 23/11/2009 |