Provider Demographics
NPI:1629296991
Name:MOBATI, DANIEL AFSHIN (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:AFSHIN
Last Name:MOBATI
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 LA SALLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611
Mailing Address - Country:US
Mailing Address - Phone:415-902-3923
Mailing Address - Fax:
Practice Address - Street 1:2522 DANA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-2895
Practice Address - Country:US
Practice Address - Phone:510-848-1055
Practice Address - Fax:510-848-9100
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412861223S0112X
CAA85226204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery