| NPI | 1598136889 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEJMAN NASIBI CEO 310-922-0221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry |
| Additional Taxonomies | 1223P0106X Dentist Oral and Maxillofacial Pathology |
| 122300000X Dentist (Licence: CA 57456) | |
| 1223E0200X Dentist Endodontics | |
| 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CA 60575) | |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2021-11-08 |