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General NPI Number Information
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NPI Number | 1922134600
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Entity Type | Individual
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Provider Name | ALEXANDER ARCEO VIZCARRA D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14930 IMPERIAL HWY SUITE D
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City | LA MIRADA
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State | CA
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Zip | 90638-2100
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Country | US
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Telephone | 562-941-3216
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Fax | 562-946-4033
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Provider Business Mailing Address
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Address Line | 3135 YORKSHIRE WAY
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-5119
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Country | US
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Telephone | 562-694-8499
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Fax | 562-946-4033
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 035799
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License Number State | CA
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