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General NPI Number Information
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NPI Number | 1063630739
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Entity Type | Organization
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Legal Business Name | ISMAIL ELSHERIF DDS A PROF CORP
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 08/18/2008
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Provider Practice Location Address
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Address Line | 4980 BARRANCA PKWY #203
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City | IRVINE
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State | CA
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Zip | 92604-8653
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Country | US
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Telephone | 949-551-5805
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Fax | 949-551-5835
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Provider Business Mailing Address
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Address Line | 4980 BARRANCA PKWY #203
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City | IRVINE
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State | CA
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Zip | 92604-8653
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Country | US
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Telephone | 949-551-5805
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Fax | 949-551-5835
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Authorized Official
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Title or Position | PRESIDENT
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Name | ISMAIL IBRAHIM ELSHERIF
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Credential | DO
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Telephone | 626-617-8079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 47883
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License Number State | CA
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