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General NPI Number Information
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NPI Number | 1548533029
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Entity Type | Organization
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Legal Business Name | CARLA BELGARDE-DURU DDS INC
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Dates
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Enumeration Date | 02/15/2012
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 3756 SANTA ROSALIA DR STE 517
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City | LOS ANGELES
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State | CA
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Zip | 90008-3656
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Country | US
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Telephone | 323-298-7992
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Fax | 323-298-7993
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Provider Business Mailing Address
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Address Line | 3756 SANTA ROSALIA DR STE 517
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City | LOS ANGELES
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State | CA
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Zip | 90008-3656
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Country | US
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Telephone | 323-298-7992
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Fax | 323-298-7993
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLA BELGARDE-DURU
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Credential | DDS
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Telephone | 323-243-2117
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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 | 60931
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License Number State | CA
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