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2542 E Florence Ave #a Huntington Park CA 90255 | |
| (323) 582-0755 | |
| (323) 582-7392 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 2542 E Florence Ave, Huntington Park, California |
| Authorized Official Name and Position | Payam Mojab (PRESIDENT) |
| Authorized Official Contact | 3235820755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2542 E Florence Ave #a Huntington Park CA 90255 Ph: (323) 582-0755 | 2542 E Florence Ave #a Huntington Park CA 90255 Ph: (323) 582-0755 |
| NPI Number | 1861558470 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861558470 | NPI | - | NPPES |
| G9394201 | Other | CA | DENTICAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 38334 (California) | Primary |
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