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22429 Foothill Blvd Hayward CA 94541-4024 | |
| (408) 600-5722 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 22429 Foothill Blvd, Hayward, California |
| Authorized Official Name and Position | Evangeline Memoracion (OWNER) |
| Authorized Official Contact | 4086005722 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
22429 Foothill Blvd Hayward CA 94541-4024 Ph: (408) 600-5722 | 22429 Foothill Blvd Hayward CA 94541-4024 Ph: (408) 600-5722 |
| NPI Number | 1154793206 |
|---|---|
| Provider Enumeration Date | 10/28/2015 |
| Last Update Date | 10/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154793206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 56995 (California) | Primary |
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