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NPI Code Detail

MEDICARE: DR. MICHAEL NAZARIAN D.D.S.

MEDICARE:  DR. MICHAEL  NAZARIAN  D.D.S.
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
11223G0001XGeneral Practice Dentistry53250CA

General Provider Information

NPI Number : 1790084416
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL NAZARIAN D.D.S.
Provider Business Mailing Address
First Line : 10551 W PICO BLVD
Second Line : 2ND FLOOR
City : LOS ANGELES
State : CA
Zip : 90064-2319
Country : US
Telephone Number : 310-475-7336
Fax Number :
Provider Business Practice Location Address
First Line : 10551 W PICO BLVD
Second Line : 2ND FLOOR
City : LOS ANGELES
State : CA
Zip : 90064-2319
Country : US
Telephone Number : 310-475-7336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2011
Last Update Date : 03/21/2011

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Directions to “ DR. MICHAEL NAZARIAN D.D.S.” Practice Location

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