Provider Demographics
NPI:1013224310
Name:TORABIAN, MARYAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARYAM
Middle Name:
Last Name:TORABIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MARYAM
Other - Middle Name:
Other - Last Name:ABULHASAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2312 HOMEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-5148
Mailing Address - Country:US
Mailing Address - Phone:916-213-7845
Mailing Address - Fax:
Practice Address - Street 1:2441 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-5121
Practice Address - Country:US
Practice Address - Phone:916-213-7845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA597231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice