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General NPI Number Information
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NPI Number | 1780803825
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Entity Type | Organization
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Legal Business Name | M HAGHIGHATPOUR, DDS, INC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13624 HAWTHORNE BLVD SUITE 205
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City | HAWTHORNE
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State | CA
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Zip | 90250
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Country | US
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Telephone | 310-856-6574
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Fax | 310-856-6578
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Provider Business Mailing Address
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Address Line | 13624 HAWTHORNE BLVD SUITE 205
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City | HAWTHORNE
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State | CA
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Zip | 90250
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Country | US
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Telephone | 310-856-6574
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Fax | 310-856-6578
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOHSEN HAGHIGHATPOUR
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Credential | MD, DDS
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Telephone | 310-856-6574
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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 | CA 49327
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License Number State | CA
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