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General NPI Number Information
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NPI Number | 1063900868
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Entity Type | Individual
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Provider Name | NATHAN RABIZADEH DDS
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Gender | Male
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Dates
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Enumeration Date | 04/26/2018
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 29219 CANWOOD ST STE 250
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1591
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Country | US
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Telephone | 183-503-3288
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Fax |
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Provider Business Mailing Address
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Address Line | 29219 CANWOOD ST STE 250
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City | AGOURA HILLS
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State | CA
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Zip | 91301-1591
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Country | US
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Telephone | 818-350-3328
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 102938
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License Number State | CA
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