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General NPI Number Information
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NPI Number | 1265221105
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Entity Type | Organization
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Legal Business Name | ABNER MAHBOOBIAN DENTAL CORPORATION
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 12124 GARFIELD AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-8033
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Country | US
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Telephone | 323-775-9070
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Fax |
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Provider Business Mailing Address
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Address Line | 12124 GARFIELD AVE
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City | SOUTH GATE
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State | CA
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Zip | 90280-8033
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Country | US
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Telephone | 310-435-5115
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OMEED MAHBOOBIAN
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Credential | DDS
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Telephone | 424-261-5115
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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 |
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License Number State |
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