Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 14343 | NV |
Y | 2084N0600X | Clinical Neurophysiologist | A128441 | CA |
NPI | 1639381619 |
---|---|
Provider Name | Sadiq Lafta Altamimi |
First Address | Pomona, CA 91767-2009 |
Second Address | Pomona, CA 91767-2009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 03/07/2014 |