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General NPI Number Information
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NPI Number | 1225237357
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Entity Type | Individual
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Provider Name | SANAH AMIR SOHRAB D.D.S
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Gender | Male
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1824 W VERDUGO AVE
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City | BURBANK
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State | CA
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Zip | 91506-2150
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Country | US
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Telephone | 818-566-8715
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Fax | 818-528-8784
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Provider Business Mailing Address
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Address Line | 1824 WEST VERDUGO AVENUE
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City | BURBANK
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State | CA
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Zip | 91506
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Country | US
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Telephone | 818-566-8715
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Fax | 818-528-8784
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 55741
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License Number State | CA
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