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Organization
USC ORAL AND MAXILLOFACIAL FACULTY PRACTICE
Active
Organization
USC ORAL AND MAXILLOFACIAL FACULTY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE ROSADO (OFFICE MANAGER)
(213) 740-9648
Entity
Organization
Contact information
Practice address
925 W 34TH ST, SUITE #149, LOS ANGELES, CA 90089-0058
(213) 740-9648
Mailing address
925 WEST 34TH STREET, SUITE 149, LOS ANGELES, CA 90089
(213) 740-9648
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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