Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 48699 | CA |
N | 1223D0001X | Dental Public Health | 48699 | CA |
NPI | 1154730349 |
---|---|
Provider Name | Miss Zahra Amirani |
First Address | West Hills, CA 91307-1732 |
Second Address | West Hills, CA 91307-1732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2014 |
Last Update Date | 12/08/2014 |