Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 226218 | MA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | C166730 | CA |
N | 207VG0400X | Gynecologist | 226218 | MA |
N | 207VG0400X | Gynecologist | C166730 | CA |
NPI | 1952382756 |
---|---|
Provider Name | Tanaz R. Ferzandi |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 07/09/2020 |