Provider Demographics
NPI:1386723930
Name:KAMBIZ D ABADI DMD INC
Entity type:Organization
Organization Name:KAMBIZ D ABADI DMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMBIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWLAT ABADI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:710-202-6040
Mailing Address - Street 1:2500 OVERLAND AVE
Mailing Address - Street 2:A
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-3333
Mailing Address - Country:US
Mailing Address - Phone:310-202-6040
Mailing Address - Fax:310-202-6810
Practice Address - Street 1:2500 OVERLAND AVE
Practice Address - Street 2:A
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-3333
Practice Address - Country:US
Practice Address - Phone:310-202-6040
Practice Address - Fax:310-202-6810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37101261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental