MEDICARE: JAMES MOBASER 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	1223G0001X	General Practice Dentistry	46891	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G9233501	OTHER	CA	DENTI CAL

General Provider Information

NPI Number	:	1326180993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES MOBASER DDS INC

Provider Business Mailing Address
First Line	:	2390 N GLENDALE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90039-3209
Country	:	US
Telephone Number	:	323-913-9900
Fax Number	:	323-669-3967

Provider Business Practice Location Address
First Line	:	2390 N GLENDALE BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90039-3209
Country	:	US
Telephone Number	:	323-913-9900
Fax Number	:	323-669-3967

Authorized Official
Title or Position	:	CEO
Name	:	JAMES N MOBASER
Credential	:	DDS
Telephone Number	:	323-913-9900

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	08/22/2020

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Directions to “JAMES MOBASER DDS INC ” Practice Location

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