MEDICARE: DR. M. CAMILLE NEAGU DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	44342	CA

General Provider Information

NPI Number	:	1508861873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. M. CAMILLE NEAGU DDS, MS

Provider Business Mailing Address
First Line	:	3002 HYPERION AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-2564
Country	:	US
Telephone Number	:	323-913-9960
Fax Number	:

Provider Business Practice Location Address
First Line	:	194 S ALVARADO ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-2211
Country	:	US
Telephone Number	:	213-201-4608
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	03/19/2009

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