Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | A64871 | CA |
NPI | 1043229453 |
---|---|
Provider Name | Mosen Istwani |
First Address | Riverside, CA 92503-0311 |
Second Address | Riverside, CA 92503-0311 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 21/03/2013 |