Healthcare Provider Details

I. General information

NPI: 1497955819
Provider Name (Legal Business Name): MRS. SOHEILA AGHEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 LEXINGTON AVE
WEST HOLLYWOOD CA
90046-6213
US

IV. Provider business mailing address

7720 LEXINGTON AVE
WEST HOLLYWOOD CA
90046-6213
US

V. Phone/Fax

Practice location:
  • Phone: 323-394-7771
  • Fax:
Mailing address:
  • Phone: 323-394-7771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberRDHAP138
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: