Individual
NIMA EBRAHIMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
11645 WILSHIRE BLVD STE 1001, LOS ANGELES, CA 90025-6808
(310) 620-8140
Mailing address
11645 WILSHIRE BLVD STE 1001, LOS ANGELES, CA 90025-6808
(310) 620-8140
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
60241
CA
1223G0001X
General Practice Dentistry
019.028258
IL
1223G0001X
General Practice Dentistry
12011522A
IN
1223P0300X
Periodontics
Primary
60241
CA
Other
Enumeration date
10/02/2010
Last updated
04/04/2022
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