| Hamid Cohen Kheradyar, DDS | |
|
138 S Gaffey St, San Pedro, CA 90731-2430 | |
| (310) 514-9100 | |
| Not Available |
| Full Name | Hamid Cohen Kheradyar |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | 138 S Gaffey St, San Pedro, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851469985 | NPI | - | NPPES |
| D39023 | Other | CA | DENTI-CAL TREATING PROVID |
| G-898601 | Other | CA | DENTI-CAL BILLING PROVIDE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 39023 (California) | Primary |
| Entity Name | Hamid Cohen Kheradyar Dds Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891993036 PECOS PAC ID: 7214238138 Enrollment ID: O20151218001449 |
| Mailing Address | Practice Location Address |
|---|---|
| Hamid Cohen Kheradyar, DDS 138 S Gaffey St, San Pedro, CA 90731-2430 Ph: (310) 514-9100 | Hamid Cohen Kheradyar, DDS 138 S Gaffey St, San Pedro, CA 90731-2430 Ph: (310) 514-9100 |
Erika Nakamura Gomez, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 520 W 7th St, San Pedro, CA 90731 Phone: 310-832-5361 | |
Dr. Arthur G Kaiser, DDS Dentist Medicare: Medicare Enrolled Practice Location: 946 N Western Ave, San Pedro, CA 90732 Phone: 310-831-0735 Fax: 310-831-9784 | |
Dr. Sheila Lynne Barron-jacobs, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 737 W 9th St, San Pedro, CA 90731 Phone: 310-833-5367 Fax: 310-833-6112 | |
Dr. Won Sur Park, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 531 W 7th St Ste B, San Pedro, CA 90731 Phone: 310-831-0003 Fax: 310-626-4166 | |
Dr. Aldwin Philip Lumanlan, Dentist Medicare: Not Enrolled in Medicare Practice Location: 946 N Western Ave, San Pedro, CA 90732 Phone: 310-831-0735 | |
Dr. Christopher A Groat, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1350 W 7th St B,, San Pedro, CA 90732 Phone: 310-832-5133 Fax: 310-832-1150 | |
Dr. Robert F Autore, DMD Dentist Medicare: Medicare Enrolled Practice Location: 1350 W 7th St, San Pedro, CA 90732 Phone: 310-832-3257 |