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NPI Code Detail

MEDICARE: DR. DANIEL KHORSHAD

MEDICARE:  DR. DANIEL  KHORSHAD
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
1122300000XDentist62441CA
21223X0400XOrthodontics and Dentofacial Orthopedics Dentistry62441CA

General Provider Information

NPI Number : 1255772182
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL KHORSHAD
Provider Business Mailing Address
First Line : 269 S BEVERLY DR
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90212-3851
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 755 W RANCHO VISTA BLVD
Second Line :
City : PALMDALE
State : CA
Zip : 93551-3735
Country : US
Telephone Number : 661-265-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2013
Last Update Date : 06/18/2019

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Directions to “ DR. DANIEL KHORSHAD ” Practice Location

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