Individual
ANDREW IKAZAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11340 W OLYMPIC BLVD STE 360, LOS ANGELES, CA 90064-1624
(310) 473-2727
Mailing address
11340 W OLYMPIC BLVD STE 360, LOS ANGELES, CA 90064-1624
(310) 473-2727
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
105743
CA
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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