| Hamid Cohen Kheradyar, Dds, Inc. | |
|
138 S Gaffey St San Pedro CA 90731-2430 | |
| (310) 514-9100 | |
| (310) 514-9119 |
| Full Name | Hamid Cohen Kheradyar, Dds, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 138 S Gaffey St, San Pedro, California |
| Authorized Official Name and Position | Hamid Cohen Kheradyar (OWNER) |
| Authorized Official Contact | 3105149100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hamid Cohen Kheradyar, Dds, Inc. 138 S Gaffey St San Pedro CA 90731-2430 Ph: (310) 514-9100 | Hamid Cohen Kheradyar, Dds, Inc. 138 S Gaffey St San Pedro CA 90731-2430 Ph: (310) 514-9100 |
| NPI Number | 1891993036 |
|---|---|
| Provider Enumeration Date | 07/10/2007 |
| Last Update Date | 07/10/2007 |
| Medicare PECOS PAC ID | 7214238138 |
|---|---|
| Medicare Enrollment ID | O20151218001449 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891993036 | NPI | - | NPPES |
| 39023 | Other | CA | DENTIST |
| 444495 | Other | CA | PERIODONTIST |
| G89860 | Other | CA | DENTI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Hamid Kheradyar |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1851469985 PECOS PAC ID: 0749581668 Enrollment ID: I20151221000006 |
Coeli Tuvera Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 312 N Gaffey St, Suite 201, San Pedro, CA 90731 Phone: 310-833-7348 Fax: 310-833-0697 | |
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Assistance League Of San Pedro-south Bay Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1441 W 8th St, San Pedro, CA 90732 Phone: 310-832-8355 Fax: 310-832-8460 | |
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