Organization
IWAMOTO ENTERPRISES, INC.
Active
Other names
Golden State X-Ray
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC TAKEO IWAMOTO (CEO/PRESIDENT)
(818) 506-6861
Entity
Organization
Contact information
Practice address
5451 LAUREL CANYON BLVD, SUITE 202, VALLEY VILLAGE, CA 91607-2180
(818) 506-6861
(818) 506-3643
Mailing address
5451 LAUREL CANYON BLVD, SUITE 202, VALLEY VILLAGE, CA 91607-2180
(818) 506-6861
(818) 506-3643
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
FAC00046448
CA
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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