Individual
ALLA RAPOPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7601 CANBY AVE, SUITE 4, RESEDA, CA 91335-2953
(818) 774-9933
(818) 774-9939
Mailing address
7601 CANBY AVE, SUITE 4, RESEDA, CA 91335-2953
(818) 774-9933
(818) 774-9939
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
48358
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27-1134685
TAX ID
CA
01
—
48358
DENTAL LICENSE NUMBER
CA
01
—
G93289-01
DENTI-CAL PROVIDER NUMBER
CA
Enumeration date
02/08/2007
Last updated
12/24/2015
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