Healthcare Provider Details

I. General information

NPI: 1437568565
Provider Name (Legal Business Name): OSCAR G. ALCALDE, D.D.S, APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2014
Last Update Date: 10/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 PARAMOUNT BLVD SUITE 303
DOWNEY CA
90241-3331
US

IV. Provider business mailing address

10800 PARAMOUNT BLVD SUITE 303
DOWNEY CA
90241-3331
US

V. Phone/Fax

Practice location:
  • Phone: 562-862-4543
  • Fax:
Mailing address:
  • Phone: 562-862-4543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number42719
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number42719
License Number StateCA

VIII. Authorized Official

Name: OSCAR G ALCALDE
Title or Position: DENTIST
Credential: DDS
Phone: 562-862-4543