Individual
DEREK HENRY PATAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
932 N BRAND BLVD STE A, GLENDALE, CA 91202-2905
(818) 843-4322
Mailing address
932 N BRAND BLVD STE A, GLENDALE, CA 91202-2905
(818) 843-4322
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105389
CA
1223G0001X
General Practice Dentistry
105389
CA
Other
Enumeration date
08/28/2020
Last updated
05/17/2023
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