Individual
POOYAN NASIBI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1835 S BENTLEY AVE APT 6, LOS ANGELES, CA 90025-4324
(424) 208-4055
Mailing address
1835 S BENTLEY AVE APT 6, LOS ANGELES, CA 90025-4324
(424) 208-4055
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
63152
CA
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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