Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 020A80782 | CA |
NPI | 1023066891 |
---|---|
Provider Name | Morteza Moosavi Farr |
First Address | San Jose, CA 95116-1914 |
Second Address | San Jose, CA 95116-1914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 18/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00AX80780 | (05) | CA |
H07328 | (02) | CA |