Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | B4052901 | CA |
NPI | 1033105481 |
---|---|
Provider Name | Meher Babian |
First Address | Glendale, CA 91205-3263 |
Second Address | Glendale, CA 91205-3263 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2005 |
Last Update Date | 08/07/2007 |