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NPI Code Detail

MEDICARE: DR. MAHSHID FARHOUMAND D.D.S.

MEDICARE:  DR. MAHSHID  FARHOUMAND  D.D.S.
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
1122300000XDentist44168CA

General Provider Information

NPI Number : 1639373400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAHSHID FARHOUMAND D.D.S.
Provider Business Mailing Address
First Line : 23024 LAKE FOREST DR STE A
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-1328
Country : US
Telephone Number : 949-716-7166
Fax Number :
Provider Business Practice Location Address
First Line : 23024 LAKE FOREST DR STE A
Second Line :
City : LAGUNA HILLS
State : CA
Zip : 92653-1328
Country : US
Telephone Number : 949-716-7166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/08/2007

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Directions to “ DR. MAHSHID FARHOUMAND D.D.S.” Practice Location

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