Healthcare Provider Details

I. General information

NPI: 1477417426
Provider Name (Legal Business Name): MASOUDI HOSSAIN AMIGOS DENTAL FOR KIDS & ADULTS PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

274 S RAMPART BLVD
LOS ANGELES CA
90057-1404
US

IV. Provider business mailing address

274 S RAMPART BLVD
LOS ANGELES CA
90057-1404
US

V. Phone/Fax

Practice location:
  • Phone: 213-538-2009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: FARAN MASOUDI
Title or Position: DENTIST
Credential: DDS
Phone: 213-538-2009