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General NPI Number Information
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NPI Number | 1922513225
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Entity Type | Organization
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Legal Business Name | MICHEL ELYSON DDS & RAMIN ASSILI DDS,A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 12/08/2017
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Provider Practice Location Address
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Address Line | 9535 RESEDA BLVD STE 203
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City | NORTHRIDGE
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State | CA
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Zip | 91324-6027
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Country | US
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Telephone | 818-349-6379
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Fax | 818-349-7539
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Provider Business Mailing Address
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Address Line | 9535 RESEDA BLVD STE 203
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City | NORTHRIDGE
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State | CA
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Zip | 91324-6027
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Country | US
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Telephone | 818-349-6373
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Fax | 818-349-7539
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHEL H ELYSON
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Credential |
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Telephone | 323-263-2125
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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 | 40605
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License Number State | CA
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