Organization
CHAMKASEM, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PISHYA CHAMKASEM DDS (CEO)
(714) 573-1224
Entity
Organization
Contact information
Practice address
17542 IRVINE BLVD, SUITE D, TUSTIN, CA 92780-3155
(714) 573-1224
Mailing address
17542 IRVINE BLVD, SUITE D, TUSTIN, CA 92780-3155
(714) 573-1224
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
50043
CA
Other
Enumeration date
07/15/2006
Last updated
03/24/2008
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