MEDICARE: DR. HOOSIK NAJARIAN DDS

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
1	122300000X	Dentist	37356	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G9056301	OTHER	CA	MEDICAL

General Provider Information

NPI Number	:	1225136856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOOSIK NAJARIAN DDS

Provider Business Mailing Address
First Line	:	10724 RIVERSIDE DRIVE
Second Line	:
City	:	TOLUCA LAKE
State	:	CA
Zip	:	91602-2313
Country	:	US
Telephone Number	:	818-769-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	10724 RIVERSIDE DRIVE
Second Line	:
City	:	TOLUCA LAKE
State	:	CA
Zip	:	91602-2313
Country	:	US
Telephone Number	:	818-769-1111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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