MEDICARE: DR. MARCELA GIRALDO BUENDIA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	56579	CA

General Provider Information

NPI Number	:	1023288461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCELA GIRALDO BUENDIA DDS

Provider Business Mailing Address
First Line	:	2521 E FLORENCE AVE
Second Line	:	SUITE B-2
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4755
Country	:	US
Telephone Number	:	323-582-4600
Fax Number	:	323-582-4611

Provider Business Practice Location Address
First Line	:	2521 E FLORENCE AVE
Second Line	:	SUITE B-2
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4755
Country	:	US
Telephone Number	:	323-582-4600
Fax Number	:	323-582-4611

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	02/29/2008

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