Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A25620 | CA |
N | 207ND0900X | Dermatopathologist | A25620 | CA |
NPI | 1447318043 |
---|---|
Provider Name | Mr. Oshin Bojalian |
First Address | Glendale, CA 91203-1821 |
Second Address | Glendale, CA 91203-1821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 20/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C03851 | (02) |