MEDICARE: FARZAD KOHANBASH DDS INC

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	41441	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1992914675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARZAD KOHANBASH DDS INC

Provider Business Mailing Address
First Line	:	1720 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-5804
Country	:	US
Telephone Number	:	323-733-0570
Fax Number	:	323-733-0540

Provider Business Practice Location Address
First Line	:	1720 S WESTERN AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-5804
Country	:	US
Telephone Number	:	323-733-0570
Fax Number	:	323-733-0540

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	10/14/2021

Similar Medicare Providers

1245315662 — JENNY YAN YAM
Practice Location Address:

1732 S WESTERN AVE
LOS ANGELES, CA
90006-5804

Practice Phone: 323-733-9390
Practice Fax: 323-766-8251

1942526157 — FARZADKOHANBASH INC. DBA UNITEDDENTALOFFICE
Practice Location Address:

1720 S WESTERN AVE
LOS ANGELES, CA
90006-5804

Practice Phone: 323-733-0570
Practice Fax: 323-733-0540

1134176613 — WALGREEN CO
Practice Location Address:

3724 CRENSHAW BLVD
LOS ANGELES, CA
90016-5804

Practice Phone: 323-292-7261
Practice Fax:

1770862757 — MEGAN OSER PH.D.
Practice Location Address:

100 UCLA MEDICAL PLAZA SUITE 205
LOS ANGELES, CA
90095-5804

Practice Phone: 310-208-5400
Practice Fax: 310-208-3788

1629400825 — DR. ASHLEY LYNNEA WILLIAMS PHARMD
Practice Location Address:

3724 CRENSHAW BLVD
LOS ANGELES, CA
90016-5804

Practice Phone: 323-292-7261
Practice Fax:

1073044624 — DIAMOND MARIE GOODWIN MD, MHS
Practice Location Address:

8631 W 3RD ST STE 830E
LOS ANGELES, CA
90048-5804

Practice Phone: 310-423-6600
Practice Fax:

Directions to “ FARZAD KOHANBASH DDS INC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.