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Individual
BEHROOZ DAVID SOOFER
Active
Individual
BEHROOZ DAVID SOOFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4059
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E40591
BLUESHIELD
CA
05
—
000E40592
—
CA
01
—
480031462
MEDICARE RAILROAD
CA
01
—
E4059
BLUE CROSS
CA
01
—
E4059
LICENSE NUMBER
—
Enumeration date
09/07/2005
Last updated
11/18/2023
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