| Edward Farajzadeh, Dds Apdc | |
|
13983 Mango Dr Ste 106 Del Mar CA 92014-3146 | |
| (858) 792-6662 | |
| Not Available |
| Full Name | Edward Farajzadeh, Dds Apdc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13983 Mango Dr Ste 106, Del Mar, California |
| Authorized Official Name and Position | Edward Farajzadeh (OWNER) |
| Authorized Official Contact | 8587926662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Farajzadeh, Dds Apdc 13983 Mango Dr Ste 106 Del Mar CA 92014-3146 Ph: (858) 792-6662 | Edward Farajzadeh, Dds Apdc 13983 Mango Dr Ste 106 Del Mar CA 92014-3146 Ph: (858) 792-6662 |
| NPI Number | 1952872517 |
|---|---|
| Provider Enumeration Date | 12/07/2018 |
| Last Update Date | 10/17/2019 |
| Medicare PECOS PAC ID | 3274961271 |
|---|---|
| Medicare Enrollment ID | O20200324003573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952872517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Edward Farajzadeh |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1700895166 PECOS PAC ID: 4183052186 Enrollment ID: I20200324003671 |
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