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General NPI Number Information
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NPI Number | 1750269205
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Entity Type | Individual
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Provider Name | BAHAREH POUYA DDS
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Gender | Female
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Dates
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Enumeration Date | 08/23/2025
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Last Update Date | 08/23/2025
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Provider Practice Location Address
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Address Line | 10833 LE CONTE AVE # CHS10157
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City | LOS ANGELES
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State | CA
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Zip | 90095-3075
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Country | US
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Telephone | 310-794-1929
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Fax | 310-206-5302
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Provider Business Mailing Address
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Address Line | 10833 LE CONTE AVE # CHS10157
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City | LOS ANGELES
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State | CA
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Zip | 90095-3075
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Country | US
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Telephone | 323-645-0599
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Fax | 310-206-5302
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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 | 1223X2210X
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Taxonomy Name | Orofacial Pain Dentistry
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License Number | 41820
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License Number State | TX
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