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Provider Information for 1841578390

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DR. MICKEL JOURABCHI D.D.S.

Gender: MALE

Individual NPI: 1841578390

Calendar Last Updated: 2014-08-27

Details

Name Value
NPI 1841578390
Enumeration Date 2011-08-02
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 5118 NEWCASTLE AVE
ENCINO, CA 91316-3511
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 5118 NEWCASTLE AVE
ENCINO, CA 91316-3511
United States

Phone: 818-342-3814 | Fax:
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 63660