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NPI Code Detail

MEDICARE: DR. SARVENAZ ANGHA DDS

MEDICARE:  DR. SARVENAZ  ANGHA  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
11223P0300XPeriodontics55438CA

General Provider Information

NPI Number : 1619151008
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARVENAZ ANGHA DDS
Provider Business Mailing Address
First Line : 1509 PANDORA AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90024-6111
Country : US
Telephone Number : 415-246-8182
Fax Number :
Provider Business Practice Location Address
First Line : 1509 PANDORA AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90024-6111
Country : US
Telephone Number : 415-246-8182
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2007
Last Update Date : 07/22/2022

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Directions to “ DR. SARVENAZ ANGHA DDS” Practice Location

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