| NPI | 1407117286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLIAN LI Secretary 626-287-8333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 38976) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 39833) |
| 1223G0001X Dentist, General Practice (Licence: CA 55414) | |
| 1223G0001X Dentist, General Practice (Licence: CA 59880) | |
| 1223G0001X Dentist, General Practice (Licence: CA 56589) | |
| 1223P0300X Dentist, Periodontics (Licence: CA 53175) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 45136) | |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2015-05-07 |