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General NPI Number Information
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NPI Number | 1558593178
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Entity Type | Organization
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Legal Business Name | MEHRNAZ IRANI DMD,INC
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Dates
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Enumeration Date | 08/15/2009
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Last Update Date | 08/15/2009
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Provider Practice Location Address
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Address Line | 950 ESCONDIDO AVE STE B
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City | VISTA
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State | CA
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Zip | 92083-5208
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Country | US
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Telephone | 760-208-4030
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Fax | 760-650-0098
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Provider Business Mailing Address
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Address Line | 12463 RANCHO BERNARDO RD # 525
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City | SAN DIEGO
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State | CA
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Zip | 92128-2143
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Country | US
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Telephone | 858-414-7705
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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. MEHRNAZ IRANI
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Credential | DMD
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Telephone | 858-414-7705
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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 | 52063
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License Number State | CA
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