Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | A80162 | CA |
NPI | 1013904424 |
---|---|
Provider Name | Saied Habibipour |
First Address | Palm Springs, CA 92262-1231 |
Second Address | Palm Springs, CA 92262-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A801620 | (05) | CA |
H28148 | (02) | CA |