| Mahr Elder Dds Md P C | |
|
1805 Novato Blvd Suite 1 Novato CA 94947-2934 | |
| (415) 892-1190 | |
| (415) 892-7355 |
| Full Name | Mahr Elder Dds Md P C |
|---|---|
| Speciality | Dentist |
| Location | 1805 Novato Blvd, Novato, California |
| Authorized Official Name and Position | Mahr Fairuke Elder (PRESIDENT) |
| Authorized Official Contact | 4158921190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahr Elder Dds Md P C 1805 Novato Blvd Suite 1 Novato CA 94947-2934 Ph: (415) 892-1190 | Mahr Elder Dds Md P C 1805 Novato Blvd Suite 1 Novato CA 94947-2934 Ph: (415) 892-1190 |
| NPI Number | 1215128988 |
|---|---|
| Provider Enumeration Date | 08/07/2007 |
| Last Update Date | 08/10/2016 |
| Medicare PECOS PAC ID | 1456663566 |
|---|---|
| Medicare Enrollment ID | O20150702000501 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215128988 | NPI | - | NPPES |
| G93803-01 | Other | CA | MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D46586 (California) | Primary |
| Provider Name | Mahr Elder |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1841301371 PECOS PAC ID: 3173762465 Enrollment ID: I20150702000586 |
| Provider Name | Irving Riley |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1215922760 PECOS PAC ID: 6507886256 Enrollment ID: I20150728006378 |
| Provider Name | Lewis Clayman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1992799613 PECOS PAC ID: 8426078163 Enrollment ID: I20160106001417 |
| Provider Name | James Edwards |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1609914209 PECOS PAC ID: 2365725900 Enrollment ID: I20170206002655 |
| Provider Name | Willard Osibin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1205178357 PECOS PAC ID: 4688977135 Enrollment ID: I20200217004250 |
| Provider Name | Jaleh Tina Keyhani |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1043214448 PECOS PAC ID: 6608203732 Enrollment ID: I20200229000110 |
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