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General NPI Number Information
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NPI Number | 1902237845
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Entity Type | Organization
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Legal Business Name | MEHRABIAN & AMBARACHYAN DENTAL CORPORATION
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 15071 IMPERIAL HWY
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City | LA MIRADA
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State | CA
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Zip | 90638-1302
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Country | US
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Telephone | 562-947-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 15071 IMPERIAL HWY
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City | LA MIRADA
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State | CA
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Zip | 90638-1302
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Country | US
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Telephone | 562-947-7000
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. VAHAG MEHRABIAN
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Credential |
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Telephone | 818-667-1151
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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 | 51108
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License Number State | CA
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