MEDICARE: YASHAR GHORBANI 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	111488	CA

General Provider Information

NPI Number	:	1427849165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASHAR GHORBANI DDS

Provider Business Mailing Address
First Line	:	41 VISTA MIRAGE WAY
Second Line	:
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-1906
Country	:	US
Telephone Number	:	909-510-2420
Fax Number	:	909-510-2420

Provider Business Practice Location Address
First Line	:	555 S SUNRISE WAY STE 400
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92264-7894
Country	:	US
Telephone Number	:	760-904-5486
Fax Number	:

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

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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