Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 37825 | CA |
NPI | 1003996067 |
---|---|
Provider Name | Dr. Magdy W Gad |
First Address | La Mirada, CA 90638-1306 |
Second Address | La Mirada, CA 90638-1306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 08/07/2007 |