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General NPI Number Information
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NPI Number | 1114156809
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Entity Type | Organization
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Legal Business Name | H. POUSHIRAZI DMD, INC
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 08/25/2011
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Provider Practice Location Address
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Address Line | 40414 CALIFORNIA OAKS RD STE. A
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City | MURRIETA
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State | CA
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Zip | 92562-5787
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Country | US
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Telephone | 951-304-7472
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Fax |
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Provider Business Mailing Address
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Address Line | 40414 CALIFORNIA OAKS RD STE. A
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City | MURRIETA
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State | CA
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Zip | 92562-5787
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Country | US
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Telephone | 951-304-7472
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. HOMAYOUN POURSHIRAZI
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Credential |
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Telephone | 951-304-7472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 44064
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License Number State | CA
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