Individual
SEYED MOHAMMAD REZA KHODDAMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A109665
CA
2088P0231X
Pediatric Urology Physician
A109665
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A109665
CALIFORNIA STATE
CA
Enumeration date
03/28/2007
Last updated
06/01/2012
Update your record
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