| Azadeh Khajavi Dmd Inc | |
|
16516 Bernardo Center Dr Ste 210 San Diego CA 92128-2551 | |
| (858) 779-9292 | |
| Not Available |
| Full Name | Azadeh Khajavi Dmd Inc |
|---|---|
| Speciality | Dentist |
| Location | 16516 Bernardo Center Dr Ste 210, San Diego, California |
| Authorized Official Name and Position | Esther Lopez (OFFICE MANAGER) |
| Authorized Official Contact | 8587799292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Azadeh Khajavi Dmd Inc 16516 Bernardo Center Dr Ste 210 San Diego CA 92128-2551 Ph: (858) 779-9292 | Azadeh Khajavi Dmd Inc 16516 Bernardo Center Dr Ste 210 San Diego CA 92128-2551 Ph: (858) 779-9292 |
| NPI Number | 1396312997 |
|---|---|
| Provider Enumeration Date | 06/10/2021 |
| Last Update Date | 09/13/2022 |
| Medicare PECOS PAC ID | 1557738424 |
|---|---|
| Medicare Enrollment ID | O20221104002752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396312997 | NPI | - | NPPES |
| Provider Name | Azadeh Khajavi |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1366060808 PECOS PAC ID: 5193192060 Enrollment ID: I20230314000653 |
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