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NPI Code Detail

MEDICARE: MR. JUAN GABRIEL MELGAR DENTAL-ORAL ASSIST

MEDICARE:  MR. JUAN GABRIEL MELGAR  DENTAL-ORAL ASSIST
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
1126800000XDental Assistant

General Provider Information

NPI Number : 1518302686
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JUAN GABRIEL MELGAR DENTAL-ORAL ASSIST
Provider Business Mailing Address
First Line : 1443 E 58TH DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90001-1203
Country : US
Telephone Number : 424-219-8626
Fax Number :
Provider Business Practice Location Address
First Line : 1443 E 58TH DR
Second Line :
City : LOS ANGELES
State : CA
Zip : 90001-1203
Country : US
Telephone Number : 424-219-8626
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2013
Last Update Date : 05/02/2013

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Directions to “ MR. JUAN GABRIEL MELGAR DENTAL-ORAL ASSIST” Practice Location

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