Individual
MIMANSA CHOLERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 4TH ST APT 324, SAN FRANCISCO, CA 94158-2435
(650) 445-1710
Mailing address
2201 BALFOUR RD STE A, BRENTWOOD, CA 94513-4927
(650) 445-1710
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
107338
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/27/2021
Last updated
07/05/2024
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