Organization
EDWIN BARZALLO, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN O BARZALLO D.D.S. (OWNER)
(323) 263-3300
Entity
Organization
Contact information
Practice address
741 S ATLANTIC BLVD, LOS ANGELES, CA 90022-3213
(323) 263-3300
(323) 263-3400
Mailing address
741 S ATLANTIC BLVD, LOS ANGELES, CA 90022-3213
(323) 263-3300
(323) 263-3400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
49467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G9240601
—
CA
Enumeration date
04/18/2008
Last updated
04/18/2008
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