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Individual

ATOUSA NOURAFROUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 820-9933
Mailing address
12121 WILSHIRE BLVD STE 1111, LOS ANGELES, CA 90025-1188
(310) 820-9933

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
92499
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
92499
CA
Enumeration date
05/18/2021
Last updated
05/18/2021
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