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NPI Code Detail

MEDICARE: OWRANG DASTMALCHI DO INC

MEDICARE: OWRANG DASTMALCHI DO INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist20A8369CA

General Provider Information

NPI Number : 1134203771
Entity Type Code : Organization
Provider Name (Legal Business Name) : OWRANG DASTMALCHI DO INC
Provider Business Mailing Address
First Line : 23141 VERDUGO DR STE 201
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-1341
Country : US
Telephone Number : 949-215-5055
Fax Number : 949-326-5099
Provider Business Practice Location Address
First Line : 23141 VERDUGO DR STE 201
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-1341
Country : US
Telephone Number : 949-215-5055
Fax Number : 949-326-5099
Authorized Official
Title or Position : PRESIDENT
Name : OWRANG DASTMALCHI
Credential : DO
Telephone Number : 949-735-5500
Provider Enumeration Date : 10/24/2006
Last Update Date : 11/15/2023

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Directions to “OWRANG DASTMALCHI DO INC ” Practice Location

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