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General NPI Number Information
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NPI Number | 1851929707
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Entity Type | Organization
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Legal Business Name | M YAVARI DDS PC
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 909 EUCLID AVE
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City | NATIONAL CITY
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State | CA
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Zip | 91950-3855
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Country | US
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Telephone | 619-552-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 909 EUCLID AVE
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City | NATIONAL CITY
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State | CA
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Zip | 91950-3855
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Country | US
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Telephone | 619-552-3200
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Fax |
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Authorized Official
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Title or Position | TIN OWNER
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Name | DR. MANSOUREH YAVARI
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Credential | DDS
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Telephone | 619-552-3200
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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 |
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License Number State |
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