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Provider Information for 1548490410

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. YORAM KOHANZADEH D.D.S.

Gender: MALE

Individual NPI: 1548490410

Calendar   Last Updated:  2009-07-24
  Certification Date: 

Details

Name Value
NPI 1548490410
Enumeration Date 2009-07-24
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 2024 SAN YSIDRO DR
BEVERLY HILLS, CA 90210-1537
United States

Phone: 310-786-7868 | Fax: 310-786-7836
View Map External Link
Primary Practice Address 2024 SAN YSIDRO DR
BEVERLY HILLS, CA 90210-1537
United States

Phone: 310-786-7868 | Fax: 310-786-7836
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223X0400X - Dentist Orthodontics and Dentofacial Orthopedics CA 58277