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General NPI Number Information
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NPI Number | 1902192578
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Entity Type | Organization
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Legal Business Name | GITA AMINLOO, RDHAP, INC.
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 12155 WYNE CT
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City | TUSTIN
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State | CA
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Zip | 92782-1185
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Country | US
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Telephone | 949-341-5588
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Fax | 949-341-5522
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Provider Business Mailing Address
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Address Line | 12155 WYNE CT
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City | TUSTIN
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State | CA
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Zip | 92782-1185
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Country | US
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Telephone | 949-341-5588
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Fax | 949-341-5522
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. GITA AMINLOO
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Credential | RDHAP
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Telephone | 949-341-5588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 348
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License Number State | CA
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