Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 32092 | CA |
NPI | 1043682271 |
---|---|
Provider Name | Mohsen Moazami |
First Address | Concord, CA 94518-1848 |
Second Address | Concord, CA 94518-1848 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2015 |
Last Update Date | 27/10/2015 |