Individual
DR. MARK SHAHRAM YAFAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
16661 VENTURA BLVD, SUITE # 215, ENCINO, CA 91436-1914
(310) 892-1969
Mailing address
16661 VENTURA BLVD, SUITE # 215, ENCINO, CA 91436-1914
(310) 892-1969
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
50117
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
50117
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
A104572
CA
Other
Enumeration date
03/05/2007
Last updated
01/18/2011
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