Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A136713 | CA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 311786 | LA |
NPI | 1306153572 |
---|---|
Provider Name | Sina Pourtaheri |
First Address | Houma, LA 70360-4629 |
Second Address | Paterson, NJ 07503-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2010 |
Last Update Date | 21/05/2021 |