Individual
DR. LESTER MACHADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S
Contact information
Practice address
501 WASHINGTON ST, SUITE #710, SAN DIEGO, CA 92103-2231
(619) 295-6774
(619) 295-6776
Mailing address
501 WASHINGTON ST, SUITE #710, SAN DIEGO, CA 92103-2231
(619) 295-6774
(619) 295-6776
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D29080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G699841
CCS PROVIDER NUMBER
CA
01
—
00G699843
CCS PROVER NUMBER
CA
01
—
G92891-01
DENTI-CAL PROVIDER NUMBER
CA
01
—
G92891-02
DENTI-CAL PROVIDER NUMBER
CA
Enumeration date
03/14/2006
Last updated
02/10/2010
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