Provider Demographics
NPI:1639872724
Name:MESTCHIAN, YASAMAN (DMD)
Entity Type:Individual
Prefix:
First Name:YASAMAN
Middle Name:
Last Name:MESTCHIAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 TRAMONTO DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-5387
Mailing Address - Country:US
Mailing Address - Phone:310-756-7333
Mailing Address - Fax:
Practice Address - Street 1:25 TRAMONTO DR
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-5387
Practice Address - Country:US
Practice Address - Phone:310-756-7333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program