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Shabnam Khanideh

  • Female

Medical Specialty

Professional ID

  • NPI: 1366576332
  • PECOS ID: 6507082005
  • Enrollment ID: I20141204000977
  • Credential(MD, DO, DPM):
  • Medical School: Boston Univ Goldman School Of Dental Medicine
  • Medical School Graduation Year: 2006

Medical Practices

  • Organization Name: Pouyan Dds And Khanideh Dds Inc
  • Group Practice ID assigned by PECOS: 4880975663
  • Number of Group Practice member: 0

Location

  • Address1: 2730 Wilshire Blvd
  • Address2: Suite 100
  • City: Santa Monica
  • State: California
  • Zip Code: 90403
  • Phone Number: (818)385-3500

Medicare

  • Medicare Assignment: Yes
  • Report Quality of Care to Physician Quality Reporting System (PQRS):
  • Used Electronic health record (EHR):