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Organization
FARZAD MAZLOOMI DMD INC.
Active
Organization
FARZAD MAZLOOMI DMD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FARZAD MAZLOOMI DMD (OWNER)
(559) 250-8861
Entity
Organization
Contact information
Practice address
8330 LONG BEACH BLVD STE 107, SOUTH GATE, CA 90280-2073
(323) 582-5411
(323) 582-5568
Mailing address
8330 LONG BEACH BLVD STE 107, SOUTH GATE, CA 90280-2073
(323) 582-5411
(323) 582-5568
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102653
DENTIST
CA
Enumeration date
11/19/2019
Last updated
06/04/2020
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