MEDICARE: REEM KABBARAH 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	1223P0221X	Pediatric Dentistry	51267	CA

General Provider Information

NPI Number	:	1750578860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REEM KABBARAH DDS

Provider Business Mailing Address
First Line	:	10582 W PICO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-2332
Country	:	US
Telephone Number	:	818-231-2698
Fax Number	:

Provider Business Practice Location Address
First Line	:	9975 ROBBINS DR
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-1641
Country	:	US
Telephone Number	:	818-231-2698
Fax Number	:

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

Provider Enumeration Date	:	10/02/2007
Last Update Date	:	10/02/2007

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