MEDICARE: DR. OSHIN ANJIRGHOOLI DMD

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	62333	CA

General Provider Information

NPI Number	:	1598103814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OSHIN ANJIRGHOOLI DMD

Provider Business Mailing Address
First Line	:	10724 RIVERSIDE DR UNIT B
Second Line	:
City	:	TOLUCA LAKE
State	:	CA
Zip	:	91602-2313
Country	:	US
Telephone Number	:	818-509-7972
Fax Number	:

Provider Business Practice Location Address
First Line	:	10724 RIVERSIDE DR UNIT B
Second Line	:
City	:	TOLUCA LAKE
State	:	CA
Zip	:	91602-2313
Country	:	US
Telephone Number	:	818-509-7972
Fax Number	:

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

Provider Enumeration Date	:	06/08/2013
Last Update Date	:	02/25/2014

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