Individual
DR. HAMID REZA ABEDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1384 109TH AVE NE STE 200, BLAINE, MN 55434-4543
(949) 230-7692
(909) 613-0277
Mailing address
3141 MICHELSON DR UNIT 1803, IRVINE, CA 92612-5675
(949) 230-7692
(909) 613-0277
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
43300
CA
1223E0200X
Endodontics
Primary
S7-129C
NV
261QD0000X
Dental Clinic/Center
S179
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-4784432
TAX ID#
CA
Enumeration date
11/08/2006
Last updated
03/02/2023
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