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General NPI Number Information
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NPI Number | 1760584650
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Entity Type | Individual
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Provider Name | SEYED BABAK MOSTAAN DDS
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Gender | Male
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3301 EL CAMINO REAL STE 280
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City | ATHERTON
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State | CA
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Zip | 94027
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Country | US
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Telephone | 650-562-0590
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Fax | 650-562-0596
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Provider Business Mailing Address
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Address Line | 26100 DUVAL WAY
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City | LOS ALTOS HILLS
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State | CA
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Zip | 94022
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Country | US
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Telephone | 650-947-9668
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 50958
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License Number State | CA
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