Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | C55769 | CA |
NPI | 1457691685 |
---|---|
Provider Name | Saeed-Ur-Rehman Awan |
First Address | Orange, CA 92868-4203 |
Second Address | Orange, CA 92868-4203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2013 |
Last Update Date | 25/02/2013 |