Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant | 20875 | CA |
NPI | 1023593316 |
---|---|
Provider Name | Mrs. Alma Ydalia Perez |
First Address | Whittier, CA 90601-1116 |
Second Address | Whittier, CA 90601-1116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2018 |
Last Update Date | 02/10/2018 |