Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A65689 | CA |
Y | 207VX0201X | Gynecologic Oncologist | A65689 | CA |
NPI | 1518998244 |
---|---|
Provider Name | Sanaz Memarzadeh |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 12/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A656890 | (05) | CA |
H95835 | (02) | CA |