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Provider Information for 1467510248

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1467510248

Calendar   Last Updated:  2007-07-08
  Certification Date: 


Name Value
NPI 1467510248
Enumeration Date 2006-12-05
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 6256 NAPOLI COURT
LONG BEACH, CA 90803-4800
United States

Phone: 562-494-7809 | Fax: 562-494-7809
View Map External Link
Primary Practice Address 5828 CHERRY AVE
LONG BEACH, CA 90805-4406
United States

Phone: 562-422-6838 | Fax: 562-494-7809
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist CA 50122