Diana Marcela Medina DDS

NPI 1003827551 - Dentist - 1223S0112X

NPI Details
NPI 1003827551
Gender Female
Enumeration Date 08/10/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
11980 SAN VICENTE BLVD
SUITE 505
LOS ANGELES CA, 90049-5012, US
Phone (310) 820-6691
Fax (310) 820-6041
Business Location
10620 EASTBORNE AVE
APT # 302
LOS ANGELES CA, 90024-5985, US
Phone (310) 490-6674
Fax
Toxanomy
Taxonomy Code 1223S0112X
License State California
License Number 50643
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According to our database, Dr. Diana Marcela Medina DDS NPI is 1003827551, taxonomy code is 1223S0112X and license number is 50643, license state is located at California. Diana Marcela Medina DDS physically located at 11980 San Vicente Blvd, Los Angeles CA, 90049-5012. NPI Number Diana Marcela Medina DDS has the Individual type.

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1003827551 NPI number is provided on an as is basis without warranty of any kind. 1003827551 is maintained by the National Plan & Provider Enumeration System. The contents of Diana Marcela Medina DDS are for informational purposes only.