| Phd Dental Group | |
|
3000 Whittier Blvd Los Angeles CA 90023-1637 | |
| (310) 927-5848 | |
| Not Available |
| Full Name | Phd Dental Group |
|---|---|
| Speciality | Dentist |
| Location | 3000 Whittier Blvd, Los Angeles, California |
| Authorized Official Name and Position | Pedram Bina (CEO) |
| Authorized Official Contact | 3104332722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phd Dental Group 3000 Whittier Blvd Los Angeles CA 90023-1637 Ph: (310) 927-5848 | Phd Dental Group 3000 Whittier Blvd Los Angeles CA 90023-1637 Ph: (310) 927-5848 |
| NPI Number | 1255656823 |
|---|---|
| Provider Enumeration Date | 04/07/2010 |
| Last Update Date | 06/09/2023 |
| Medicare PECOS PAC ID | 3779707849 |
|---|---|
| Medicare Enrollment ID | O20140610002395 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255656823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Pedram Bina |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1134300866 PECOS PAC ID: 4688898752 Enrollment ID: I20140610002508 |
| Provider Name | Parham Sage |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1154562338 PECOS PAC ID: 3779707559 Enrollment ID: I20140618000314 |
| Provider Name | Amir Korouri |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1730383365 PECOS PAC ID: 9931328820 Enrollment ID: I20140908001301 |
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