Provider Demographics
NPI:1013177625
Name:MALBOUBI, SAEID (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAEID
Middle Name:
Last Name:MALBOUBI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 MONROE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3656
Mailing Address - Country:US
Mailing Address - Phone:949-200-0600
Mailing Address - Fax:
Practice Address - Street 1:464 MONROE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3656
Practice Address - Country:US
Practice Address - Phone:949-200-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524261223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics