Healthcare Provider Details

I. General information

NPI: 1255961611
Provider Name (Legal Business Name): MORVARID ALETOMEH DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2020
Last Update Date: 01/24/2020
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2833 PACIFIC COAST HWY
TORRANCE CA
90505-6701
US

IV. Provider business mailing address

2833 PACIFIC COAST HWY
TORRANCE CA
90505-6701
US

V. Phone/Fax

Practice location:
  • Phone: 424-999-5478
  • Fax:
Mailing address:
  • Phone: 424-999-5478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MORVARID ALETOMEH
Title or Position: OWNER/PEDIATRIC DENTIST
Credential: DMD
Phone: 424-999-5478