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4292 Lincoln Blvd Marina Del Rey CA 90292-5655 | |
| (310) 578-5000 | |
| (310) 578-5003 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 4292 Lincoln Blvd, Marina Del Rey, California |
| Authorized Official Name and Position | Mohdsameer Yi Aljanedi (PRESIDENT) |
| Authorized Official Contact | 3103868188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4292 Lincoln Blvd Marina Del Rey CA 90292-5655 Ph: (310) 578-5000 | 4292 Lincoln Blvd Marina Del Rey CA 90292-5655 Ph: (310) 578-5000 |
| NPI Number | 1437314317 |
|---|---|
| Provider Enumeration Date | 07/21/2008 |
| Last Update Date | 06/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437314317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 41577 (California) | Primary |
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