Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A31834 | CA |
NPI | 1083827414 |
---|---|
Provider Name | Parvaneh Abadee-Amoli |
First Address | Corona Del Mar, CA 92625-1239 |
Second Address | Costa Mesa, CA 92626-4865 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A318340 | (05) | CA |
E70259 | (02) | CA |