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9100 Wilshire Blvd Suite W448 Beverly Hills CA 90212-3415 | |
| (310) 273-9919 | |
| (310) 273-3319 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 9100 Wilshire Blvd, Beverly Hills, California |
| Authorized Official Name and Position | Wendy Canon (OFFICE MANAGER) |
| Authorized Official Contact | 3102739919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
9100 Wilshire Blvd Suite W448 Beverly Hills CA 90212-3415 Ph: (310) 273-9919 | 9100 Wilshire Blvd Suite W448 Beverly Hills CA 90212-3415 Ph: (310) 273-9919 |
| NPI Number | 1922267913 |
|---|---|
| Provider Enumeration Date | 06/04/2008 |
| Last Update Date | 05/17/2024 |
| Medicare PECOS PAC ID | 1153558481 |
|---|---|
| Medicare Enrollment ID | O20131212001167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922267913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 35173 (California) | Primary |
| Provider Name | Parsa T Zadeh |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1659530889 PECOS PAC ID: 0042447385 Enrollment ID: I20131212001255 |
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