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General NPI Number Information
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NPI Number | 1932703790
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Entity Type | Organization
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Legal Business Name | DR AZADEH ABRAHAM DENTAL INC.
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 8131 ROSECRANS AVE STE 101
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City | PARAMOUNT
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State | CA
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Zip | 90723-2758
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Country | US
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Telephone | 562-634-2984
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Fax | 562-634-2986
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Provider Business Mailing Address
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Address Line | 8131 ROSECRANS AVE STE 101
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City | PARAMOUNT
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State | CA
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Zip | 90723-2758
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Country | US
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Telephone | 562-634-2984
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Fax | 562-634-2986
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. AZADEH ABRAHAM
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Credential |
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Telephone | 619-846-3830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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