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Organization
VIJAYA KV PRABHU. DDS. A PROFFESSIONAL CORP
Active
Organization
VIJAYA KV PRABHU. DDS. A PROFFESSIONAL CORP
Active
Other names
El Norte Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAYA KV PRABHU DDS (PRESIDENT)
(760) 480-5600
Entity
Organization
Contact information
Practice address
306 W EL NORTE PKWY, SUITE D & E, ESCONDIDO, CA 92026-1960
(760) 480-5600
(760) 418-4321
Mailing address
306 W EL NORTE PKWY, SUITE D & E, ESCONDIDO, CA 92026-1960
(760) 480-5600
(760) 418-4321
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
38736
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1223G0001X
DENTIST-GENERAL PRACTICE
CA
Enumeration date
04/11/2007
Last updated
08/22/2020
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