MEDICARE: NOOZHAN KARIMI 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	1223P0700X	Prosthodontics	DE61219899	WA

General Provider Information

NPI Number	:	1659034676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOOZHAN KARIMI DDS

Provider Business Mailing Address
First Line	:	5927 BALBOA AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2711
Country	:	US
Telephone Number	:	213-810-6564
Fax Number	:	858-225-0410

Provider Business Practice Location Address
First Line	:	5927 BALBOA AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-2711
Country	:	US
Telephone Number	:	213-810-6564
Fax Number	:	858-225-0410

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

Provider Enumeration Date	:	10/17/2021
Last Update Date	:	10/17/2021

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