Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT9766 | CA |
NPI | 1043578396 |
---|---|
Provider Name | Sina Hamidi |
First Address | Glendale, CA 91205-1200 |
Second Address | Glendale, CA 91205-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 17/09/2012 |