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Organization

KEIVAN SARRAF, DDS, INC

Active
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Organization

KEIVAN SARRAF, DDS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KEIVAN SARRAF DDS (CEO)
(310) 460-9546
Entity
Organization

Contact information

Practice address
5703 S VERMONT AVE, LOS ANGELES, CA 90037-3930
(310) 460-9546
Mailing address
10600 WILSHIRE BLVD APT 406, LOS ANGELES, CA 90024-4561
(310) 460-9546

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
52466
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
G89663
CA
Enumeration date
05/11/2008
Last updated
06/16/2008
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