Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 103045 | CA |
NPI | 1003355686 |
---|---|
Provider Name | Mona Nejad |
First Address | Torrance, CA 90503-4420 |
Second Address | Torrance, CA 90503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2017 |
Last Update Date | 09/08/2018 |