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Organization
IRENE NOSRATI, DDS, AND EREZ NOSRATI, DMD, INC.
Active
Organization
IRENE NOSRATI, DDS, AND EREZ NOSRATI, DMD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRENE NOSRATI DDS (PRESIDENT)
(317) 507-9033
Entity
Organization
Contact information
Practice address
525 NAUTILUS ST, LA JOLLA, CA 92037-6139
(317) 507-9033
Mailing address
5175 PEARLMAN WAY, SAN DIEGO, CA 92130-3715
(317) 507-9033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
65156
CA
1223P0300X
Periodontics
100669
CA
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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