Healthcare Provider Details

I. General information

NPI: 1588061253
Provider Name (Legal Business Name): ANGELA ONDINE ESPIRITU D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2014
Last Update Date: 11/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19218 BLOOMFIELD AVE
CERRITOS CA
90703-7106
US

IV. Provider business mailing address

19218 BLOOMFIELD AVE
CERRITOS CA
90703-7106
US

V. Phone/Fax

Practice location:
  • Phone: 562-261-4481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number41404
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: