| Hossein K. Ebrahim, D.m.d. Inc, | |
|
32122 Paseo Adelanto Suite 1b San Juan Capistrano CA 92675-3605 | |
| (949) 493-6166 | |
| (949) 493-8910 |
| Full Name | Hossein K. Ebrahim, D.m.d. Inc, |
|---|---|
| Speciality | Dentist |
| Location | 32122 Paseo Adelanto, San Juan Capistrano, California |
| Authorized Official Name and Position | Hossein Kia Ebrahim (PRESIDENT/DENTIST) |
| Authorized Official Contact | 9493506350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hossein K. Ebrahim, D.m.d. Inc, 32122 Paseo Adelanto Suite 1b San Juan Capistrano CA 92675-3605 Ph: (949) 493-6166 | Hossein K. Ebrahim, D.m.d. Inc, 32122 Paseo Adelanto Suite 1b San Juan Capistrano CA 92675-3605 Ph: (949) 493-6166 |
| NPI Number | 1124388913 |
|---|---|
| Provider Enumeration Date | 05/25/2012 |
| Last Update Date | 05/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124388913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 36307 (California) | Primary |
| 122300000X | Dentist | 37778 (California) | Secondary |
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