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General NPI Number Information
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NPI Number | 1962564013
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Entity Type | Individual
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Provider Name | MONA TAHA MOHAMMED GAD DDS
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Gender | Female
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 500 N MAIN ST
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City | SANTA ANA
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State | CA
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Zip | 92701-4620
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Country | US
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Telephone | 714-973-9006
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Fax |
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Provider Business Mailing Address
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Address Line | 2775 MESA VERDE DR E A 103
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City | COSTA MESA
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State | CA
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Zip | 92626-4957
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Country | US
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Telephone | 805-264-5778
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 50910
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License Number State | CA
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