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General NPI Number Information
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NPI Number | 1487785291
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Entity Type | Organization
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Legal Business Name | PAYMAN PIRNAZAR, D.D.S., M.S., INC.
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 11620 WILSHIRE BLVD SUITE 720
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City | LOS ANGELES
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State | CA
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Zip | 90025-1706
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Country | US
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Telephone | 310-443-9596
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Fax |
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Provider Business Mailing Address
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Address Line | 11620 WILSHIRE BLVD SUITE 720
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City | LOS ANGELES
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State | CA
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Zip | 90025-1706
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Country | US
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Telephone | 310-443-9596
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. PAYMAN PIRNAZAR
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Credential | D.D.S, M.S.
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Telephone | 310-443-9596
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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 | 44433
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License Number State | CA
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