Individual
RAVINESH PATHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1348 W 35TH PL, LOS ANGELES, CA 90007-3404
(206) 850-6201
Mailing address
1348 W 35TH PL, LOS ANGELES, CA 90007-3404
(206) 850-6201
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
RDH30453
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30453
—
CA
Enumeration date
03/29/2017
Last updated
03/29/2017
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