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1210 N Long Beach Blvd Ste 196 Compton CA 90221-1685 | |
| (424) 785-8708 | |
| (424) 785-8718 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1210 N Long Beach Blvd Ste 196, Compton, California |
| Authorized Official Name and Position | Elsa Wendy Hernandez (OWNER/PRESIDENT) |
| Authorized Official Contact | 6192511312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12920 Runway Rd Unit 310 Playa Vista CA 90094-2313 Ph: (424) 785-8708 | 1210 N Long Beach Blvd Ste 196 Compton CA 90221-1685 Ph: (424) 785-8708 |
| NPI Number | 1053866517 |
|---|---|
| Provider Enumeration Date | 08/24/2016 |
| Last Update Date | 08/24/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053866517 | NPI | - | NPPES |
| 1497938401 | Other | CA | DENTIST |
| 1437580644 | Other | CA | ELSA W HERNANDEZ, DDS, INC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 56388 (California) | Primary |
Korouri Sage Bina Professional Dental Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 609 S Long Beach Blvd, Compton, CA 90221 Phone: 310-876-2534 | |
Linda C. Onyeador, D.d.s., Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 555 W Compton Blvd, Suite #103, Compton, CA 90220 Phone: 310-762-9292 Fax: 310-762-6680 |