Individual
DR. AZADEH TAVARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
11633 SAN VICENTE BLVD, LOS ANGELES, CA 90049-6511
(818) 324-6121
Mailing address
18160 CHARDON CIR, ENCINO, CA 91316-4415
(818) 324-6121
(818) 324-6121
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
101690
CA
Other
Enumeration date
08/31/2017
Last updated
08/31/2017
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