Provider Demographics
NPI:1194920876
Name:SOHEIL JOURABCHI D.D.S INC.
Entity type:Organization
Organization Name:SOHEIL JOURABCHI D.D.S INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOHEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOURABCHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-585-2100
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:90255-2537
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA423361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty