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NPI Code Detail

MEDICARE: ALEXANDER VASSERMAN DDS A PROFESSIONAL CORPORATION

MEDICARE: ALEXANDER VASSERMAN DDS A PROFESSIONAL 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
1122300000XDentist42014CA

General Provider Information

NPI Number : 1215292883
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALEXANDER VASSERMAN DDS A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 6200 WILSHIRE BLVD STE 1602
Second Line :
City : LOS ANGELES
State : CA
Zip : 90048-5817
Country : US
Telephone Number : 323-931-8400
Fax Number :
Provider Business Practice Location Address
First Line : 6200 WILSHIRE BLVD STE 1602
Second Line :
City : LOS ANGELES
State : CA
Zip : 90048-5817
Country : US
Telephone Number : 323-931-8400
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. ALEXANDER VASSERMAN I
Credential : D.D.S., B.S.
Telephone Number : 323-931-8400
Provider Enumeration Date : 07/10/2012
Last Update Date : 07/10/2012

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Directions to “ALEXANDER VASSERMAN DDS A PROFESSIONAL CORPORATION ” Practice Location

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