| |
12124 Garfield Ave South Gate CA 90280-8033 | |
(562) 633-4354 | |
Not Available |
Full Name | |
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Speciality | Dentist |
Location | 12124 Garfield Ave, South Gate, California |
Authorized Official Name and Position | Dona Torbati (OWNER) |
Authorized Official Contact | 5626334354 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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12124 Garfield Ave South Gate CA 90280-8033 Ph: (562) 633-4354 | 12124 Garfield Ave South Gate CA 90280-8033 Ph: (562) 633-4354 |
NPI Number | 1497287650 |
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Provider Enumeration Date | 03/28/2017 |
Last Update Date | 03/28/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497287650 | NPI | - | NPPES |
1376798264 | Other | CA | NPI |
1861764318 | Other | CA | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 57788 (California) | Primary |
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