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8935 San Ramon Rd Dublin CA 94568-1061 | |
| (925) 300-9559 | |
| (925) 524-2485 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 8935 San Ramon Rd, Dublin, California |
| Authorized Official Name and Position | Chona S. Lardizabal (OWNER / DENTIST) |
| Authorized Official Contact | 2096275328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8935 San Ramon Rd Dublin CA 94568-1061 Ph: (925) 300-9559 | 8935 San Ramon Rd Dublin CA 94568-1061 Ph: (925) 300-9559 |
| NPI Number | 1225338270 |
|---|---|
| Provider Enumeration Date | 10/25/2010 |
| Last Update Date | 10/25/2010 |
| Medicare PECOS PAC ID | 2961830732 |
|---|---|
| Medicare Enrollment ID | O20200310002937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225338270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 56826 (California) | Primary |
| Provider Name | Chona Lardizabal |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1295903557 PECOS PAC ID: 2668807736 Enrollment ID: I20200310002935 |
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