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General NPI Number Information
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NPI Number | 1053870162
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Entity Type | Organization
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Legal Business Name | IMELDA D SOTO DDS INC
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 03/18/2019
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Provider Practice Location Address
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Address Line | 8018 STEWART AND GRAY RD
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City | DOWNEY
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State | CA
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Zip | 90241-5122
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Country | US
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Telephone | 562-923-7799
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Fax |
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Provider Business Mailing Address
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Address Line | 8018 STEWART AND GRAY RD
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City | DOWNEY
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State | CA
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Zip | 90241-5122
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Country | US
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Telephone | 562-923-7799
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IMELDA SOTO
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Credential | DDS
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Telephone | 626-419-7917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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