Provider Demographics
NPI:1952019705
Name:HAKIMZADEH AND REYHANI DENTAL OFFICE OF SIGNAL HILL, INC.,C/O PASHA HA
Entity Type:Organization
Organization Name:HAKIMZADEH AND REYHANI DENTAL OFFICE OF SIGNAL HILL, INC.,C/O PASHA HA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIT
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-210-4802
Mailing Address - Street 1:1830 E WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-1938
Mailing Address - Country:US
Mailing Address - Phone:562-424-9949
Mailing Address - Fax:562-381-8187
Practice Address - Street 1:1830 E WILLOW ST
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-1938
Practice Address - Country:US
Practice Address - Phone:562-424-9949
Practice Address - Fax:562-381-8187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376790907OtherDENTAL OFFICE