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General NPI Number Information
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NPI Number | 1497499644
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Entity Type | Organization
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Legal Business Name | DIANA E ZSCHASCHEL, DDS A PROFESSIONAL DENTAL CORP
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Dates
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Enumeration Date | 04/25/2022
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 11600 WILSHIRE BLVD STE 220
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City | LOS ANGELES
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State | CA
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Zip | 90025-1782
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Country | US
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Telephone | 310-854-6102
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Fax | 310-854-6161
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Provider Business Mailing Address
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Address Line | 11600 WILSHIRE BLVD STE 220
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City | LOS ANGELES
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State | CA
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Zip | 90025-1782
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Country | US
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Telephone | 310-854-6102
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Fax | 310-854-6161
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. DIANA E ZSCHASCHEL
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Credential |
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Telephone | 310-854-6102
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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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