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General NPI Number Information
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NPI Number | 1063960987
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Entity Type | Organization
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Legal Business Name | LILI MIRTORABI D.D.S., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/20/2016
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 13940 LAMBERT RD
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City | WHITTIER
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State | CA
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Zip | 90605-2424
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Country | US
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Telephone | 562-325-5404
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Fax |
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Provider Business Mailing Address
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Address Line | 13940 LAMBERT RD
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City | WHITTIER
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State | CA
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Zip | 90605-2424
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Country | US
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Telephone | 562-325-5404
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LILI MIRTORABI
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Credential | M.D
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Telephone | 323-228-9282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 42574
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License Number State | CA
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