MEDICARE: DR. AFAF EZZAT ISKANDER 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	1223G0001X	General Practice Dentistry	43171	CA

General Provider Information

NPI Number	:	1891856589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AFAF EZZAT ISKANDER DDS

Provider Business Mailing Address
First Line	:	1526 SINALOA AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-2744
Country	:	US
Telephone Number	:	626-398-7791
Fax Number	:

Provider Business Practice Location Address
First Line	:	709 N LAKE AVE
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91104-4558
Country	:	US
Telephone Number	:	626-797-8900
Fax Number	:

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	03/18/2015

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