| Jirawan Srivivatanakul D.d.s., Inc. | |
|
17360 Norwalk Blvd Cerritos CA 90703-2748 | |
| (562) 402-8899 | |
| Not Available |
| Full Name | Jirawan Srivivatanakul D.d.s., Inc. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 17360 Norwalk Blvd, Cerritos, California |
| Authorized Official Name and Position | Jirawan Srivivatanakul (DENTIST) |
| Authorized Official Contact | 5624028899 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jirawan Srivivatanakul D.d.s., Inc. 17360 Norwalk Blvd Cerritos CA 90703-2748 Ph: (562) 402-8899 | Jirawan Srivivatanakul D.d.s., Inc. 17360 Norwalk Blvd Cerritos CA 90703-2748 Ph: (562) 402-8899 |
| NPI Number | 1265624399 |
|---|---|
| Provider Enumeration Date | 08/13/2007 |
| Last Update Date | 08/13/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265624399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 48771 (California) | Primary |
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