Individual
ROMMEL LATO PASTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDA
Contact information
Practice address
1839 VASSAR ST, GLENDALE, CA 91204-2936
(310) 408-9892
Mailing address
1839 VASSAR ST, GLENDALE, CA 91204-2936
(310) 408-9892
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
85423
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85423
—
CA
Enumeration date
08/31/2019
Last updated
08/31/2019
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