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Individual

HOMA HABIBI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
19500 PRUNERIDGE AVE APT 10212, CUPERTINO, CA 95014-6755
(408) 828-5096
Mailing address
P.O.BOX 9292, SAN JOSE, CA 95157
(408) 828-5096

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA47103
CA

Other

Enumeration date
01/08/2015
Last updated
01/08/2015
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