| NPI | 1003120148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELMIRA KHODAPANAH President 858-245-2426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 43989) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2010-07-30 |