MEDICARE: PARVIZ AZAR-MEHR,DMD

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
1	1223P0700X	Prosthodontics

General Provider Information

NPI Number	:	1629252432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARVIZ AZAR-MEHR,DMD

Provider Business Mailing Address
First Line	:	10921 WILSHIRE BLVD STE 501
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4001
Country	:	US
Telephone Number	:	310-443-3030
Fax Number	:	310-443-5660

Provider Business Practice Location Address
First Line	:	10921 WILSHIRE BLVD STE 501
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4001
Country	:	US
Telephone Number	:	310-443-3030
Fax Number	:	310-443-5660

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PARVIZ AZAR-MEHR I
Credential	:	DMD
Telephone Number	:	310-443-3030

Provider Enumeration Date	:	12/28/2007
Last Update Date	:	12/28/2007

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