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General NPI Number Information
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NPI Number | 1386116135
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Entity Type | Organization
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Legal Business Name | FOROUD HAKIM, DDS, INC
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Dates
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Enumeration Date | 12/18/2018
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 2301 CAMINO RAMON STE 282
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City | SAN RAMON
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State | CA
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Zip | 94583-2000
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Country | US
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Telephone | 925-866-8890
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Fax | 925-866-8893
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Provider Business Mailing Address
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Address Line | 2301 CAMINO RAMON STE 282
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City | SAN RAMON
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State | CA
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Zip | 94583-2000
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Country | US
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Telephone | 925-866-8890
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Fax | 925-866-8893
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JENNIFER JEPSEN
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Credential |
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Telephone | 925-866-8890
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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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