Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | A153417 | CA |
N | 2084N0402X | Child Neurologist | 257817 | MA |
NPI | 1346669389 |
---|---|
Provider Name | Samra Vazirian |
First Address | Torrance, CA 90503-4583 |
Second Address | Torrance, CA 90503-4583 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2014 |
Last Update Date | 20/04/2021 |