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NPI Code Detail

MEDICARE: AFSHIN HABASHI DDS

MEDICARE: AFSHIN HABASHI 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
11223G0001XGeneral Practice Dentistry3207NV
21223G0001XGeneral Practice Dentistry43789CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21671512OTHERNVUNITED CONCORDIA PROVIDER

General Provider Information

NPI Number : 1710908660
Entity Type Code : Individual
Provider Name (Legal Business Name) : AFSHIN HABASHI DDS
Provider Business Mailing Address
First Line : 7956 ENTRADA LAZANJA
Second Line :
City : SAN DIEGO
State : CA
Zip : 92127-3620
Country : US
Telephone Number : 702-338-3474
Fax Number :
Provider Business Practice Location Address
First Line : 10405 TIERRASANTA BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92124-2603
Country : US
Telephone Number : 858-492-9300
Fax Number : 858-492-9332
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2006
Last Update Date : 11/19/2009

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