Provider Demographics
NPI:1750627303
Name:TORABZADEH, MARIA (RDA)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TORABZADEH
Suffix:
Gender:F
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6046 CADILLAC AVE
Mailing Address - Street 2:APT # 7
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1732
Mailing Address - Country:US
Mailing Address - Phone:310-467-7526
Mailing Address - Fax:
Practice Address - Street 1:6046 CADILLAC AVE
Practice Address - Street 2:APT # 7
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034
Practice Address - Country:US
Practice Address - Phone:310-467-7526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66845126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant