MEDICARE: SAN GABRIEL FAMILY DENTISTRY

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1659247948
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN GABRIEL FAMILY DENTISTRY

Provider Business Mailing Address
First Line	:	531 W LAS TUNAS DR STE B
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1166
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	531 W LAS TUNAS DR STE B
Second Line	:
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-1166
Country	:	US
Telephone Number	:	626-281-1628
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CASSY LI
Credential	:
Telephone Number	:	626-281-1628

Provider Enumeration Date	:	10/14/2025
Last Update Date	:	10/14/2025

Similar Medicare Providers

1760653992 — GEORGE M. KO, D.D.S., INC.
Practice Location Address:

531 W LAS TUNAS DR , SUITE C
SAN GABRIEL, CA
91776-1166

Practice Phone: 626-284-8022
Practice Fax:

1811397664 — JUNG W SEO DDS, INC
Practice Location Address:

531 W LAS TUNAS DR , SUITE A
SAN GABRIEL, CA
91776-1166

Practice Phone: 626-282-0884
Practice Fax: 626-282-1884

1245782606 — EFREN N. JUAREZ DDS INC
Practice Location Address:

531 W LAS TUNAS DR , STE D
SAN GABRIEL, CA
91776-1166

Practice Phone: 626-289-9075
Practice Fax:

1184133076 — ALBERT OH DENTISTRY PC
Practice Location Address:

531 W LAS TUNAS DR STE A
SAN GABRIEL, CA
91776-1166

Practice Phone: 626-282-0884
Practice Fax:

1760080998 — TOKIN KIM DDS
Practice Location Address:

531 W LAS TUNAS DR STE A
SAN GABRIEL, CA
91776-1166

Practice Phone: 714-323-8007
Practice Fax:

1497626980 — TOKIN KIM DDS INC.
Practice Location Address:

531 W LAS TUNAS DR STE A
SAN GABRIEL, CA
91776-1166

Practice Phone: 626-282-0884
Practice Fax:

Directions to “SAN GABRIEL FAMILY DENTISTRY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.