Provider Demographics
NPI:1396857785
Name:JOURABCHI, SOHEIL (DDS)
Entity type:Individual
Prefix:DR
First Name:SOHEIL
Middle Name:
Last Name:JOURABCHI
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 1:5600 PACIFIC BLVD
Mailing Address - Street 2:SUITE#A
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-2618
Mailing Address - Country:US
Mailing Address - Phone:323-585-2100
Mailing Address - Fax:323-585-6545
Practice Address - Street 1:5600 PACIFIC BLVD
Practice Address - Street 2:SUITE#A
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-2537
Practice Address - Country:US
Practice Address - Phone:323-585-2100
Practice Address - Fax:323-585-6545
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA423361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice