Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | G077458 | CA |
N | 207RP1001X | Pulmonary Disease | G077458 | CA |
NPI | 1003801358 |
---|---|
Provider Name | Mr. Ramin Khashayar |
First Address | Walnut Creek, CA 94598-2884 |
Second Address | Walnut Creek, CA 94598-2884 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 08/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G19570 | (02) |