Individual
MS. ELIZA S. AZAD SHAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
8853 W OLYMPIC BLVD, BEVERLY HILLS, CA 90211-3605
(310) 600-3933
Mailing address
1377 S BEVERLY GLEN BLVD, #407, LOS ANGELES, CA 90024-5214
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
17638
CA
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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