| Alireza | |
|
13422 Pomerado Rd Ste 202 Poway CA 92064-3548 | |
| (858) 679-0142 | |
| (858) 679-0165 |
| Full Name | Alireza |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 13422 Pomerado Rd Ste 202, Poway, California |
| Authorized Official Name and Position | Alireza Khansari (PERIODONTIST) |
| Authorized Official Contact | 8586790142 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alireza Po Box 1334 Poway CA 92074-1334 Ph: (858) 679-0142 | Alireza 13422 Pomerado Rd Ste 202 Poway CA 92064-3548 Ph: (858) 679-0142 |
| NPI Number | 1588723951 |
|---|---|
| Provider Enumeration Date | 12/08/2006 |
| Last Update Date | 02/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588723951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (California) | Primary |
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