Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 51981 | CA |
NPI | 1023156775 |
---|---|
Provider Name | Mr. Shahram Nabipour |
First Address | San Francisco, CA 94123-1947 |
Second Address | Hayward, CA 94544-1809 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/07/2007 |