Individual
MR. EHSAN MOKHTARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15243 VANOWEN ST, #205, VAN NUYS, CA 91405-3605
(818) 780-7555
Mailing address
5825 RESEDA BLVD, #341, TARZANA, CA 91356-2024
(818) 343-6890
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
45149
CA
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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