Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1023255544 |
---|---|
Provider Name | Miss Maria Elena Oseguera |
First Address | Huntington Park, CA 90255 |
Second Address | Los Angeles, CA 90017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2009 |
Last Update Date | 21/01/2009 |