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NPI Code Detail

MEDICARE: DR. RAMIN JAY RASSOULI D.D.S.

MEDICARE:  DR. RAMIN JAY RASSOULI  D.D.S.
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 Dentistry44068CA

General Provider Information

NPI Number : 1942329164
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAMIN JAY RASSOULI D.D.S.
Provider Business Mailing Address
First Line : 925 E SAN ANTONIO DR
Second Line : #15
City : LONG BEACH
State : CA
Zip : 90807-2210
Country : US
Telephone Number : 562-428-5963
Fax Number : 562-428-3210
Provider Business Practice Location Address
First Line : 925 E SAN ANTONIO DR
Second Line : #15
City : LONG BEACH
State : CA
Zip : 90807-2210
Country : US
Telephone Number : 562-428-5963
Fax Number : 562-428-3210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2007
Last Update Date : 07/08/2007

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Directions to “ DR. RAMIN JAY RASSOULI D.D.S.” Practice Location

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