Healthcare Provider Details

I. General information

NPI: 1407937378
Provider Name (Legal Business Name): PAUL GREGORY MURASHIGE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18025 GALE AVE
CITY OF INDUSTRY CA
91748-1245
US

IV. Provider business mailing address

20301 BLUFFSIDE CIR UNIT 401
HUNTINGTON BEACH CA
92646-8521
US

V. Phone/Fax

Practice location:
  • Phone: 626-965-2500
  • Fax: 909-598-5900
Mailing address:
  • Phone: 714-536-3576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number41762
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: