MEDICARE: DR. ALIREZA TORABI

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	1223P0300X	Periodontics	105687	CA
2	1223P0300X	Periodontics	32910	TX

General Provider Information

NPI Number	:	1821519349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALIREZA TORABI

Provider Business Mailing Address
First Line	:	2822 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-3032
Country	:	US
Telephone Number	:	510-975-8172
Fax Number	:

Provider Business Practice Location Address
First Line	:	2822 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-3032
Country	:	US
Telephone Number	:	323-734-9600
Fax Number	:

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

Provider Enumeration Date	:	07/06/2017
Last Update Date	:	11/19/2020

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Directions to “ DR. ALIREZA TORABI ” Practice Location

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