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General NPI Number Information
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NPI Number | 1245119981
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Entity Type | Individual
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Provider Name | LILIUOKALANI BACUNGAN RDH
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Gender | Female
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Dates
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Enumeration Date | 08/28/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 930 16TH ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-2455
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Country | US
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Telephone | 415-890-4449
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Fax |
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Provider Business Mailing Address
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Address Line | 1222 HARRISON ST APT 2504
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City | SAN FRANCISCO
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State | CA
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Zip | 94103-4476
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Country | US
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Telephone | 707-674-7443
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 36638
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License Number State | CA
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