| Everest Dental Care | |
|
2050 S. Central Ave. Los Angeles CA 90011 | |
| (323) 423-5860 | |
| Not Available |
| Full Name | Everest Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 2050 S. Central Ave., Los Angeles, California |
| Authorized Official Name and Position | Juan Pocholo B Cancio (PRESIDENT) |
| Authorized Official Contact | 3234235860 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Everest Dental Care Po Box 17665 Beverly Hills CA 90209-3665 Ph: (323) 423-5860 | Everest Dental Care 2050 S. Central Ave. Los Angeles CA 90011 Ph: (323) 423-5860 |
| NPI Number | 1417261132 |
|---|---|
| Provider Enumeration Date | 08/05/2010 |
| Last Update Date | 11/05/2019 |
| Medicare PECOS PAC ID | 9032541776 |
|---|---|
| Medicare Enrollment ID | O20191118001916 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417261132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 56585 (California) | Primary |
| Provider Name | Juan Pocholo Balingit Cancio |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1689854648 PECOS PAC ID: 0648576710 Enrollment ID: I20191118002310 |
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