Individual
DR. CARLOS OMAR FERNANDEZ DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3061 WABASH AVE, LOS ANGELES, CA 90063-2765
(626) 376-5420
Mailing address
3061 WABASH AVE, LOS ANGELES, CA 90063-2765
(626) 376-5420
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
111317
CA
Other
Enumeration date
03/14/2025
Last updated
03/14/2025
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