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General NPI Number Information
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NPI Number | 1316186794
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Entity Type | Organization
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Legal Business Name | SOHAIL PARHAM A PROF DENTAL CORP
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 4955 VAN NUYS BLVD STE 520
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1834
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Country | US
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Telephone | 818-990-4121
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Fax | 818-990-5194
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Provider Business Mailing Address
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Address Line | 4955 VAN NUYS BLVD STE 520
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-1834
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Country | US
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Telephone | 818-990-4121
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Fax | 818-990-5194
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Authorized Official
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Title or Position | OWNER
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Name | DR. SOHAIL PARHAM
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Credential | DDS
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Telephone | 818-990-4121
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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 | 38214
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License Number State | CA
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