Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | EL1881 | CA |
NPI | 1033481023 |
---|---|
Provider Name | Saieh Khademi |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90024-6970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2012 |
Last Update Date | 02/12/2015 |