Provider Demographics
NPI:1265064372
Name:PARSI, PEGAH (LAC)
Entity type:Individual
Prefix:
First Name:PEGAH
Middle Name:
Last Name:PARSI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ORCHARD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-4536
Mailing Address - Country:US
Mailing Address - Phone:949-228-1247
Mailing Address - Fax:
Practice Address - Street 1:15 ORCHARD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4536
Practice Address - Country:US
Practice Address - Phone:949-228-1247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18803171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist