Healthcare Provider Details

I. General information

NPI: 1316400252
Provider Name (Legal Business Name): HOOMAN ADAMOUS DMD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14343 BELLFLOWER BLVD
BELLFLOWER CA
90706-3135
US

IV. Provider business mailing address

14343 BELLFLOWER BLVD
BELLFLOWER CA
90706-3135
US

V. Phone/Fax

Practice location:
  • Phone: 562-866-1111
  • Fax: 562-866-1130
Mailing address:
  • Phone: 562-866-1111
  • Fax: 562-866-1130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. HOOMAN ADAMOUS
Title or Position: OWNER
Credential: DMD
Phone: 562-866-1111