Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 18195 | CA |
NPI | 1033570122 |
---|---|
Provider Name | Mojgan Hosseinipour |
First Address | Henderson, NV 89074-7759 |
Second Address | Laguna Niguel, CA 92677-5926 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2016 |
Last Update Date | 27/07/2020 |