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Organization
K KOHANI D D S A PROFESSIONAL CORPORATION
Active
Organization
K KOHANI D D S A PROFESSIONAL CORPORATION
Active
Other names
Costa Verde Dentistry & Orthodonic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMI KOHANI DDS (OWNER)
18586221007
Entity
Organization
Contact information
Practice address
4510 EXECUTIVE DR, SUITE 205, SAN DIEGO, CA 92121-3021
(858) 622-1007
(858) 622-1058
Mailing address
4510 EXECUTIVE DR, SUITE 205, SAN DIEGO, CA 92121-3021
(858) 622-1007
(858) 622-1058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
39290
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972710663
MEDICARE NPI
CA
Enumeration date
09/24/2014
Last updated
05/26/2015
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