Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 29249 | TX |
NPI | 1053743468 |
---|---|
Provider Name | Nora Haghparast Hassas |
First Address | Rancho Palos Verdes, CA 90275-5913 |
Second Address | Rancho Palos Verdes, CA 90275-5913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2013 |
Last Update Date | 07/08/2013 |