MEDICARE: KATHERINE TOUBIAN 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	1223G0001X	General Practice Dentistry	38932	CA

General Provider Information

NPI Number	:	1306910575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE TOUBIAN DDS

Provider Business Mailing Address
First Line	:	PO BOX 64516
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-0516
Country	:	US
Telephone Number	:	310-441-8888
Fax Number	:	310-441-8890

Provider Business Practice Location Address
First Line	:	2180 WESTWOOD BLVD STE 2C
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-6352
Country	:	US
Telephone Number	:	310-441-8888
Fax Number	:	310-441-8890

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

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	07/08/2007

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Directions to “ KATHERINE TOUBIAN DDS” Practice Location

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