Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 13215 | TX |
Y | 111NN0400X | Neurology | 34078 | CA |
NPI | 1275980427 |
---|---|
Provider Name | Nisreen Tayebjee |
First Address | Carlsbad, CA 92009-8453 |
Second Address | Carlsbad, CA 92009-8453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2016 |
Last Update Date | 02/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13215 | CHIROPRACTOR LICENSE (01) | TX |
34078 | CHIROPRACTIC LICENSE (01) | CA |