Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | A40473 | CA |
Y | 207WX0107X | Retina Specialist | A40473 | CA |
NPI | 1023061314 |
---|---|
Provider Name | Nasrin Mani |
First Address | Chula Vista, CA 91911-1352 |
Second Address | Chula Vista, CA 91911-1352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 05/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E79786 | (02) | CA |