Provider Demographics
NPI:1164716817
Name:SOROUDI, PAUL P (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:P
Last Name:SOROUDI
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 1:3663 TORRANCE BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4817
Mailing Address - Country:US
Mailing Address - Phone:310-543-2224
Mailing Address - Fax:
Practice Address - Street 1:3663 TORRANCE BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4817
Practice Address - Country:US
Practice Address - Phone:310-543-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-30
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA265351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice