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General NPI Number Information
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NPI Number | 1447519129
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Entity Type | Organization
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Legal Business Name | SANAH AMIR SOHRAB DDS INC
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 05/15/2012
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Provider Practice Location Address
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Address Line | 1824 WEST VERDUGO AVE.
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City | BURBANK
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State | CA
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Zip | 91506
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Country | US
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Telephone | 310-740-0667
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Fax |
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Provider Business Mailing Address
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Address Line | 1824 WEST VERDUGO AVE.
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City | BURBANK
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State | CA
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Zip | 91506
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Country | US
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Telephone |
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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. SANAH AMIR SOHRAB
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Credential | D.D.S
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Telephone | 310-740-0667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 55741
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License Number State | CA
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