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Search › California › 122300000X

Azzah Widatalla, DDS

NPI 1316544570 · on the registry since 2020 · sole proprietor

Practice

Address
5455 Wilshire Blvd Ste 850
Los Angeles, CA 90036
Phone
(323) 930-4600
Organisation at this address
Victory Care
Socal Flu Shots
Managedmed, Inc.
Therapy On Demand
Dawn M Terashita, Pc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
26

Registry record

Primary taxonomy
122300000X
122300000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2020-10-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California