| NPI | 1831493568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUEL DE GUZMAN ANGELES Dentist 562-925-4466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA 55644) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: CA 55644) |
| 302R00000X Health Maintenance Organization (Licence: CA 55644) | |
| 305R00000X Preferred Provider Organization (Licence: CA 55644) | |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-19 |