MEDICARE: DR. NAHID AMJADI

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	56056	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437342326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAHID AMJADI

Provider Business Mailing Address
First Line	:	P.O.BOX 25306
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90025
Country	:	US
Telephone Number	:	310-694-1055
Fax Number	:

Provider Business Practice Location Address
First Line	:	1451 N MONTEBELLO BLVD
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-2584
Country	:	US
Telephone Number	:	323-724-9955
Fax Number	:

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

Provider Enumeration Date	:	08/23/2007
Last Update Date	:	06/01/2010

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