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NPI Code Detail

MEDICARE: DR. ELENA AFSANEH YEGANEH-TAJIAN DDS

MEDICARE: DR. ELENA AFSANEH YEGANEH-TAJIAN DDS
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
1122300000XDentist61111CA

General Provider Information

NPI Number : 1700159050
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELENA AFSANEH YEGANEH-TAJIAN DDS
Provider Business Mailing Address
First Line : 121 N ALMONT DR APT 301
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90211-1862
Country : US
Telephone Number : 310-903-1403
Fax Number :
Provider Business Practice Location Address
First Line : 121 N ALMONT DR APT 301
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90211-1862
Country : US
Telephone Number : 310-903-1403
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2012
Last Update Date : 04/27/2015

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