Provider Demographics
NPI:1477755759
Name:AZAR-MEHR, HAN YOUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAN
Middle Name:YOUNG
Last Name:AZAR-MEHR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10921 WILSHIRE BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-4001
Mailing Address - Country:US
Mailing Address - Phone:310-443-3030
Mailing Address - Fax:310-443-5660
Practice Address - Street 1:10921 WILSHIRE BLVD STE 501
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4001
Practice Address - Country:US
Practice Address - Phone:310-443-3030
Practice Address - Fax:310-443-5660
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL33234122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist