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General NPI Number Information
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NPI Number | 1982715173
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Entity Type | Organization
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Legal Business Name | JAMSHID AZIZZADEH DDS INC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 15030 WHITTIER BLVD # 106
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City | WHITTIER
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State | CA
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Zip | 90603
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Country | US
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Telephone | 562-789-8989
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Fax | 562-789-8966
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Provider Business Mailing Address
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Address Line | 15030 WHITTIER BLVD # 106
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City | WHITTIER
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State | CA
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Zip | 90603
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Country | US
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Telephone | 562-789-8989
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Fax | 562-789-8966
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES AZIZ
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Credential | DDS
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Telephone | 562-789-8989
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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 | 39228
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License Number State | CA
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