Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | A99936 | CA |
Y | 2080P0208X | Pediatric Infectious Diseases | A99936 | CA |
NPI | 1225220205 |
---|---|
Provider Name | Nava Yeganeh |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-1437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2007 |
Last Update Date | 13/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A999360 | (05) | CA |
1225220205 | (05) | CA |