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General NPI Number Information
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NPI Number | 1366830473
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Entity Type | Organization
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Legal Business Name | DR. ROSEMARIE QUIMSON-CRUZ, DMD, INC.
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Dates
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Enumeration Date | 12/26/2014
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Last Update Date | 12/26/2014
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Provider Practice Location Address
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Address Line | 2252 BEVERLY BLVD SUITE 102
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City | LOS ANGELES
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State | CA
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Zip | 90057-2225
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Country | US
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Telephone | 213-387-6453
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Fax | 213-387-5390
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Provider Business Mailing Address
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Address Line | 2252 BEVERLY BLVD SUITE 102
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City | LOS ANGELES
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State | CA
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Zip | 90057-2225
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Country | US
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Telephone | 213-387-6453
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Fax | 213-387-5390
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Authorized Official
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Title or Position | MANAGER
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Name | MISS DENNIS B CRUZ
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Credential |
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Telephone | 213-387-6453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 44478
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License Number State | CA
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