Individual
DR. KAMRAN DASTOURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2290 KIPLING ST UNIT 2, LAKEWOOD, CO 80215-1546
(661) 466-8266
Mailing address
44015 7TH ST E, LANCASTER, CA 93535-4124
(661) 466-8266
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
000203543
CO
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
101382
CA
261QA1903X
Ambulatory Surgical Clinic/Center
A146736
CA
Other
Enumeration date
02/28/2011
Last updated
05/05/2018
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