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NPI Code Detail

MEDICARE: PARID PAKRAVAN DENTAL CORPORATION

MEDICARE: PARID PAKRAVAN DENTAL CORPORATION
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
11223G0001XGeneral Practice Dentistry39862CA

General Provider Information

NPI Number : 1164646618
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARID PAKRAVAN DENTAL CORPORATION
Provider Business Mailing Address
First Line : 9910 LONG BEACH BLVD
Second Line : SUITE A
City : LYNWOOD
State : CA
Zip : 90262-1561
Country : US
Telephone Number : 323-563-8900
Fax Number : 323-563-3434
Provider Business Practice Location Address
First Line : 9910 LONG BEACH BLVD
Second Line : SUITE A
City : LYNWOOD
State : CA
Zip : 90262-1561
Country : US
Telephone Number : 323-563-8900
Fax Number : 323-563-3434
Authorized Official
Title or Position : OWNER
Name : FARID PAKRAVAN
Credential :
Telephone Number : 323-563-8900
Provider Enumeration Date : 04/13/2007
Last Update Date : 06/24/2008

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Directions to “PARID PAKRAVAN DENTAL CORPORATION ” Practice Location

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