Healthcare Provider Details

I. General information

NPI: 1811866791
Provider Name (Legal Business Name): SEYED MOBIN TAFRESHI KHAMENEH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. MOBIN TAFRESHI

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E VINEYARD AVE
OXNARD CA
93036-1615
US

IV. Provider business mailing address

1040 FLYNN RD
CAMARILLO CA
93012-5092
US

V. Phone/Fax

Practice location:
  • Phone: 805-436-3444
  • Fax: 805-485-4160
Mailing address:
  • Phone: 805-673-3930
  • Fax: 805-659-3217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number112889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: