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General NPI Number Information
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NPI Number | 1548657984
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Entity Type | Organization
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Legal Business Name | BABAK MANESH DDS INC
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 04/23/2015
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Provider Practice Location Address
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Address Line | 16661 VENTURA BLVD STE 306
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City | ENCINO
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State | CA
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Zip | 91436-1951
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Country | US
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Telephone | 818-784-5234
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Fax | 818-784-9230
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Provider Business Mailing Address
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Address Line | 16661 VENTURA BLVD STE 306
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City | ENCINO
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State | CA
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Zip | 91436-1951
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Country | US
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Telephone | 818-784-5234
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Fax | 818-784-9230
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | DR. BABAK MANESH
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Credential | D.D.S
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Telephone | 818-784-5234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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