Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 54003 | CA |
NPI | 1043255458 |
---|---|
Provider Name | Marzieh Karkhanehchi |
First Address | Pleasanton, CA 94566-6143 |
Second Address | Pleasanton, CA 94566-6143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 26/08/2009 |