Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A60633 | CA |
Y | 207VX0000X | Obstetrician | A60633 | CA |
NPI | 1184736589 |
---|---|
Provider Name | Payman Paul Joseph |
First Address | Van Nuys, CA 91405-2231 |
Second Address | Van Nuys, CA 91405-2231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 29/06/2013 |