Individual
LADAN HAKIMJAVADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36 1ST AVE, CHARLESTOWN, MA 02129-4557
(617) 726-2947
Mailing address
36 1ST AVE, CHARLESTOWN, MA 02129-4557
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
59572
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2020
Last updated
06/17/2021
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