Individual
MRS. MAHIN REZAMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
1451 N MONTEBELLO BLVD, MONTEBELLO, CA 90640-2584
(323) 724-9955
Mailing address
3733 WHITE ASH RD, SAN BERNARDINO, CA 92407-9008
(626) 485-7714
(909) 571-5850
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NCF780A52374
ANTHEM BLUE CROSS
—
Enumeration date
06/01/2018
Last updated
06/01/2018
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