| NPI | 1619158367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY YATSHING CHUNG CEO 818-780-2062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA OMS 11) |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2007-11-23 |