| Rouzita Rashtian Dds A Professional Corporation | |
|
12301 Wilshire Blvd Ste 204 Los Angeles CA 90025-1241 | |
| (310) 622-1617 | |
| Not Available |
| Full Name | Rouzita Rashtian Dds A Professional Corporation |
|---|---|
| Speciality | Dentist |
| Location | 12301 Wilshire Blvd Ste 204, Los Angeles, California |
| Authorized Official Name and Position | Rouzita Rashtian (DOCTOR/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3106221617 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rouzita Rashtian Dds A Professional Corporation 12301 Wilshire Blvd Ste 204 Los Angeles CA 90025-1241 Ph: (310) 622-1617 | Rouzita Rashtian Dds A Professional Corporation 12301 Wilshire Blvd Ste 204 Los Angeles CA 90025-1241 Ph: (310) 622-1617 |
| NPI Number | 1861273161 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 10/12/2023 |
| Medicare PECOS PAC ID | 7719333616 |
|---|---|
| Medicare Enrollment ID | O20231030001408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861273161 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| Provider Name | Rouzita Rashtian |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1407964562 PECOS PAC ID: 8628424520 Enrollment ID: I20231030001449 |
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