Healthcare Provider Details

I. General information

NPI: 1962190272
Provider Name (Legal Business Name): AARON BACHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 03/22/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 COMPTON AVE
LOS ANGELES CA
90002-3628
US

IV. Provider business mailing address

10300 COMPTON AVE
LOS ANGELES CA
90002-3628
US

V. Phone/Fax

Practice location:
  • Phone: 323-564-4331
  • Fax:
Mailing address:
  • Phone: 323-564-4331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number108934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: