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General NPI Number Information
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NPI Number | 1689852998
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Entity Type | Organization
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Legal Business Name | CAROLINA CASTANEDA DDS, INC
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 4560 E CESAR E CHAVEZ AVE
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City | LOS ANGELES
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State | CA
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Zip | 90022-1117
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Country | US
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Telephone | 323-780-0223
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Fax | 323-780-0494
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Provider Business Mailing Address
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Address Line | 4560 CESAR E CHAVEZ AVE
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City | LOS ANGELES
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State | CA
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Zip | 90022
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Country | US
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Telephone | 323-780-0223
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Fax | 323-780-0494
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CAROLINA CASTANEDA
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Credential | DDS
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Telephone | 323-780-0223
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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 | B35852
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License Number State | CA
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