MEDICARE: MOHAMMAD ALI ZAREH DDS 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
1	122300000X	Dentist

General Provider Information

NPI Number	:	1275141384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOHAMMAD ALI ZAREH DDS INC

Provider Business Mailing Address
First Line	:	1990 WESTWOOD BLVD
Second Line	:	SUITE 250
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-8411
Country	:	US
Telephone Number	:	310-807-6564
Fax Number	:

Provider Business Practice Location Address
First Line	:	1990 WESTWOOD BLVD
Second Line	:	SUITE 250
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-8411
Country	:	US
Telephone Number	:	310-807-6564
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOHAMMAD ALI ZAREH
Credential	:	DDS
Telephone Number	:	310-807-6564

Provider Enumeration Date	:	07/15/2020
Last Update Date	:	07/15/2020

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