| Omid Shayan DDS Inc | |
|
9922 Walker St Ste C Cypress CA 90630-3097 | |
| (714) 220-0354 | |
| Not Available |
| Full Name | Omid Shayan DDS Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9922 Walker St Ste C, Cypress, California |
| Authorized Official Name and Position | Omid Shayan (PRESIDENT) |
| Authorized Official Contact | 3104337793 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omid Shayan DDS Inc 9922 Walker St Ste C Cypress CA 90630-3097 | Omid Shayan DDS Inc 9922 Walker St Ste C Cypress CA 90630-3097 Ph: (714) 220-0354 |
| NPI Number | 1992328108 |
|---|---|
| Provider Enumeration Date | 05/21/2020 |
| Last Update Date | 05/21/2020 |
| Certification Date | 05/21/2020 |
| Medicare PECOS PAC ID | 9739500745 |
|---|---|
| Medicare Enrollment ID | O20200529001742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992328108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
| Provider Name | Omid Shayan |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1275714552 PECOS PAC ID: 0648691659 Enrollment ID: I20200529001811 |
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