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General NPI Number Information
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NPI Number | 1255521068
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Entity Type | Organization
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Legal Business Name | SHAY S. SALEHRABI DDS INC
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 880B W BEVERLY BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4213
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Country | US
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Telephone | 323-726-2626
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Fax | 323-726-4090
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Provider Business Mailing Address
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Address Line | 880B W BEVERLY BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4213
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Country | US
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Telephone | 323-726-2626
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Fax | 323-726-4090
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | SHAY S SALEHRABI
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Credential | DDS
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Telephone | 323-726-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 40982
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License Number State | CA
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