| A Sabbagh-fard Dds & P. Mastour Dds Inc | |
|
5620 Sawtelle Blvd Culver City CA 90230-5508 | |
| (310) 390-6212 | |
| (310) 390-6215 |
| Full Name | A Sabbagh-fard Dds & P. Mastour Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 5620 Sawtelle Blvd, Culver City, California |
| Authorized Official Name and Position | Pedram E. Mastour (DENTIST) |
| Authorized Official Contact | 3103906212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Sabbagh-fard Dds & P. Mastour Dds Inc 5620 Sawtelle Blvd Culver City CA 90230-5508 Ph: (310) 390-6212 | A Sabbagh-fard Dds & P. Mastour Dds Inc 5620 Sawtelle Blvd Culver City CA 90230-5508 Ph: (310) 390-6212 |
| NPI Number | 1568710333 |
|---|---|
| Provider Enumeration Date | 08/27/2012 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 3072934645 |
|---|---|
| Medicare Enrollment ID | O20200608000670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568710333 | NPI | - | NPPES |
| Provider Name | Arash S Fard |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1083930408 PECOS PAC ID: 0143528505 Enrollment ID: I20190927000485 |
| Provider Name | Pedram S Mastour |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1548582026 PECOS PAC ID: 0749517399 Enrollment ID: I20200330000841 |
| Provider Name | Joshua Behnam Shayefar |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1346780715 PECOS PAC ID: 2769806850 Enrollment ID: I20200722001609 |
| Provider Name | Viviana Hewitt |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1659599520 PECOS PAC ID: 9830502517 Enrollment ID: I20210120000503 |
| Provider Name | Steven Dennis Destler |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1053547406 PECOS PAC ID: 4688088255 Enrollment ID: I20210122002245 |
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