1700108610 NPI number — MR. ARASH HAKHAMIAN DDS

Table of content: MR. ARASH HAKHAMIAN DDS (NPI 1700108610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700108610 NPI number — MR. ARASH HAKHAMIAN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAKHAMIAN
Provider First Name:
ARASH
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OMID
Provider Other First Name:
ARASH
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
A.S, B.S, D.D.S,
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1700108610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2002 S. HOOVER ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-858-7373
Provider Business Mailing Address Fax Number:
213-741-9111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8420 CALIFORNIA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTH GATE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90280
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-567-2137
Provider Business Practice Location Address Fax Number:
323-567-5514
Provider Enumeration Date:
02/18/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  59147 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)