Provider Demographics
NPI:1881603223
Name:AL-TARIFI, HALA AHMED (DDS)
Entity type:Individual
Prefix:
First Name:HALA
Middle Name:AHMED
Last Name:AL-TARIFI
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 1:1730 HUNTINGTON DR STE 102
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-4880
Mailing Address - Country:US
Mailing Address - Phone:626-799-2990
Mailing Address - Fax:626-799-2965
Practice Address - Street 1:1730 HUNTINGTON DR
Practice Address - Street 2:STE 102
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-4878
Practice Address - Country:US
Practice Address - Phone:626-799-2990
Practice Address - Fax:626-799-2965
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45803122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist