# USC ORAL AND MAXILLOFACIAL FACULTY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285024372
- **Authorized official:** MR. GEORGE ROSADO (OFFICE MANAGER)
- **Authorized official phone:** (213) 740-9648

## Contact information

- **Practice address:** 925 W 34TH ST, SUITE \#149, LOS ANGELES, CA 90089-0058
- **Practice address phone:** (213) 740-9648
- **Mailing address:** 925 WEST 34TH STREET, SUITE 149, LOS ANGELES, CA 90089
- **Mailing address phone:** (213) 740-9648

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 01/28/2015
- **Last updated:** 01/28/2015