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General NPI Number Information
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NPI Number | 1629484274
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Entity Type | Individual
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Provider Name | ALI MEHRABIAN DDS
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Gender | Male
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Dates
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Enumeration Date | 07/03/2014
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 25460 MEDICAL CENTER DR STE 200
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City | MURRIETA
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State | CA
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Zip | 92562-5985
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Country | US
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Telephone | 951-677-7322
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Fax |
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Provider Business Mailing Address
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Address Line | 2638 S AMADOR PL
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City | ONTARIO
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State | CA
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Zip | 91761-7001
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Country | US
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Telephone | 631-741-9799
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Fax |
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 058339-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 107379
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License Number State | CA
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