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DR. DIANA MARCELA MEDINA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
11980 SAN VICENTE BLVD, SUITE 505, LOS ANGELES, CA 90049-5012
(310) 820-6691
(310) 820-6041
Mailing address
10620 EASTBORNE AVE, APT # 302, LOS ANGELES, CA 90024-5985
(310) 490-6674

Taxonomy

Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
50643
CA

Other

Enumeration date
08/10/2006
Last updated
07/08/2007
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