Provider Demographics
NPI:1285715086
Name:HAMMOUDEH, JEFFREY ASHRAF (MD, DDS)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ASHRAF
Last Name:HAMMOUDEH
Suffix:
Gender:M
Credentials:MD, DDS
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Mailing Address - Street 1:6430 W SUNSET BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7901
Mailing Address - Country:US
Mailing Address - Phone:323-669-2337
Mailing Address - Fax:323-644-8488
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MS# 96
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-669-2154
Practice Address - Fax:323-669-4106
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2017-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA949912086S0122X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery