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General NPI Number Information
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NPI Number | 1245718113
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Entity Type | Organization
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Legal Business Name | MEHRABIAN DDS INC
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Dates
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Enumeration Date | 08/02/2018
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 249 E BEVERLY BLVD STE A
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City | MONTEBELLO
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State | CA
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Zip | 90640
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Country | US
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Telephone | 323-726-7500
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Fax | 323-726-7503
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Provider Business Mailing Address
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Address Line | 249 E BEVERLY BLVD STE A
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City | MONTEBELLO
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State | CA
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Zip | 90640-3799
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Country | US
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Telephone | 323-726-7500
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Fax | 323-726-7503
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VAHAG MEHRABIAN
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Credential | DDS
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Telephone | 323-726-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 51108
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License Number State | CA
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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 | 51108
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License Number State | CA
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