Individual
ALI OSTADALI MAKHMALBAF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
925 W 34TH ST # 230, LOS ANGELES, CA 90089-0058
(714) 495-0414
Mailing address
442 S PASEO SERENA, ANAHEIM, CA 92807-4214
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401412149
VA
1223P0700X
Prosthodontics
25978
TX
1223P0700X
Prosthodontics
Primary
59489
CA
Other
Enumeration date
09/08/2008
Last updated
09/11/2011
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