| NPI | 1114226172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TED YAO-TE FANG President 661-947-6201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 45458) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment |
| Enumeration Date | 2011-03-16 |
| Last Update Date | 2011-07-25 |