Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DDS100257 | CA |
NPI | 1104267475 |
---|---|
Provider Name | Truska Sabir Mahmood |
First Address | San Diego, CA 92120-5013 |
Second Address | San Diego, CA 92120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2013 |
Last Update Date | 10/08/2018 |