Healthcare Provider Details

I. General information

NPI: 1558580563
Provider Name (Legal Business Name): EUGENE SEKIGUCHI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 S ATLANTIC BLVD 1
MONTEREY PARK CA
91754-4721
US

IV. Provider business mailing address

823 S ATLANTIC BLVD 1
MONTEREY PARK CA
91754-4721
US

V. Phone/Fax

Practice location:
  • Phone: 626-281-4844
  • Fax: 626-281-4032
Mailing address:
  • Phone: 626-281-4844
  • Fax: 626-281-4032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number24176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: