Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 146587 | CA |
N | 2080P0205X | Pediatric Endocrinologist | 254479 | MA |
NPI | 1407107055 |
---|---|
Provider Name | Laya Ekhlaspour |
First Address | Palo Alto, CA 94303-3341 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2012 |
Last Update Date | 04/01/2017 |