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NPI Code Detail

MEDICARE: GOLNAZ KAVAND

MEDICARE: GOLNAZ KAVAND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry106090CA
21223X0400XOrthodontics and Dentofacial Orthopedics Dentistry30.024640OH
31223G0001XGeneral Practice Dentistry30.024640OH

General Provider Information

NPI Number : 1326531658
Entity Type Code : Individual
Provider Name (Legal Business Name) : GOLNAZ KAVAND
Provider Business Mailing Address
First Line : 3838 DUNN DR APT 608
Second Line :
City : CULVER CITY
State : CA
Zip : 90232-2776
Country : US
Telephone Number : 319-400-3949
Fax Number :
Provider Business Practice Location Address
First Line : 3150 CASE RD BLDG C
Second Line :
City : PERRIS
State : CA
Zip : 92570-5552
Country : US
Telephone Number : 951-345-4386
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2018
Last Update Date : 04/06/2021

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