Provider Demographics
NPI:1528171915
Name:KOUZ, RAMI MOUZAYEK (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMI
Middle Name:MOUZAYEK
Last Name:KOUZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 CAMPBELL STREET
Mailing Address - Street 2:APARTMENT 305
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91207
Mailing Address - Country:US
Mailing Address - Phone:818-634-8690
Mailing Address - Fax:
Practice Address - Street 1:1129 SOUTH GLENDORA AVENUE
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790
Practice Address - Country:US
Practice Address - Phone:626-919-7707
Practice Address - Fax:626-851-0985
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48302122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist