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General NPI Number Information
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NPI Number | 1467628750
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Entity Type | Individual
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Provider Name | AMIR H GHAZINOOR D.D.S
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Gender | Male
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 2362 WESTWOOD BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-2128
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Country | US
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Telephone | 310-475-3301
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Fax | 310-475-0903
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Provider Business Mailing Address
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Address Line | 2362 WESTWOOD BLVD STE 2
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City | LOS ANGELES
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State | CA
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Zip | 90064-2128
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Country | US
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Telephone | 310-475-3301
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Fax | 310-475-0903
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 41177
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License Number State | CA
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