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General NPI Number Information
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NPI Number | 1366658783
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Entity Type | Individual
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Provider Name | GLENDA CRUZ LINCHANGCO
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 6226 1 HALF WEST MANCHESTER AVE.
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City | LOS ANGELES
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State | CA
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Zip | 90045
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Country | US
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Telephone | 310-215-9156
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Fax | 310-215-3479
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Provider Business Mailing Address
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Address Line | 532 AMBRIDGE ST.
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City | LAKE ELSINORE
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State | CA
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Zip | 92532
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Country | US
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Telephone | 714-300-9759
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Fax | 310-215-3479
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 47937
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License Number State | CA
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