Organization
USC ORAL AND MAXILLOFACIAL FACULTY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE ROSADO (OFFICE MANAGER)
(213) 740-9648
Entity
Organization
Contact information
Practice address
925 W 34TH ST, SUITE #149, LOS ANGELES, CA 90089-0058
(213) 740-9648
Mailing address
925 WEST 34TH STREET, SUITE 149, LOS ANGELES, CA 90089
(213) 740-9648
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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