Elmira Khodapanah Dds Inc

NPI 1003120148 - Dentist - 1223G0001X

NPI Details
NPI 1003120148
Enumeration Date 07/30/2010
Last Updated 07/30/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name ELMIRA ELMIRA
Position PRESIDENT
Phone (619) 574-1810
Fax (619) 574-1326
Practice Location
2333 CAMINO DEL RIO S STE 140
SAN DIEGO CA, 92108-3607, US
Phone (619) 574-1810
Fax (619) 574-1326
Business Location
12079 WORLD TRADE DR UNIT 4
SAN DIEGO CA, 92128-4393, US
Phone (858) 485-8855
Fax (858) 487-0531
Toxanomy
Taxonomy Code 1223G0001X
License State California
License Number 43989
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According to our database, Elmira Khodapanah Dds Inc NPI is 1003120148, taxonomy code is 1223G0001X and license number is 43989, license state is located at California. Elmira Khodapanah Dds Inc physically located at 2333 Camino Del Rio S Ste 140, San Diego CA, 92108-3607. NPI Number 1033115704 has the healthcare provider type.

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1003120148 NPI number is provided on an as is basis without warranty of any kind. 1003120148 is maintained by the National Plan & Provider Enumeration System. The contents of Elmira Khodapanah Dds Inc are for informational purposes only.