Individual
HANIEH MOHTASHAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
437 WHISPERING TRL, IRVINE, CA 92602-0802
(949) 572-8525
Mailing address
437 WHISPERING TRL, IRVINE, CA 92602-0802
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
31759
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31759
—
CA
Enumeration date
02/11/2018
Last updated
02/11/2018
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