Individual
MR. OMAR ISLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
440 N CORONADO ST UNIT 207, LOS A NGELES, CA 90026
(818) 441-3866
Mailing address
440 N CORONADO ST APT 207, LOS ANGELES, CA 90026-4828
(818) 441-3866
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
67395
CA
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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