Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A54059 | CA |
Y | 208600000X | Surgeon | A54059 | CA |
N | 2086S0127X | Trauma Surgeon | A54059 | CA |
NPI | 1518054915 |
---|---|
Provider Name | Morad Tourah |
First Address | Santa Monica, CA 90406-1897 |
Second Address | Los Angeles, CA 90008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 04/06/2018 |