# A SABBAGH-FARD DDS & P. MASTOUR DDS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568710333
- **Authorized official:** DR. PEDRAM E. MASTOUR D.D.S (DENTIST)
- **Authorized official phone:** (310) 390-6212

## Contact information

- **Practice address:** 5620 SAWTELLE BLVD, CULVER CITY, CA 90230-5508
- **Practice address phone:** (310) 390-6212
- **Practice address fax:** (310) 390-6215
- **Mailing address:** 5620 SAWTELLE BLVD, CULVER CITY, CA 90230-5508
- **Mailing address phone:** (310) 390-6212
- **Mailing address fax:** (310) 390-6215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | CA | Yes |
| 1223P0300X | Periodontics | — | CA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | CA | — |
| 305R00000X | Preferred Provider Organization | — | CA | — |

## Other

- **Enumeration date:** 08/27/2012
- **Last updated:** 07/21/2022