Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A64657 | CA |
Y | 111NI0900X | Internist | A64657 | CA |
N | 207RN0300X | Nephrologist | A64657 | CA |
NPI | 1053391185 |
---|---|
Provider Name | Noha R Barsoum |
First Address | Van Nuys, CA 91411-2546 |
Second Address | North Hollywood, CA 91607-3429 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2006 |
Last Update Date | 22/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A646570 | (05) | CA |
H70013 | (02) | CA |