MEDICARE: MR. JOHN LOUIS VICELJA D.D.S.

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	1223G0001X	General Practice Dentistry	33396	CA

General Provider Information

NPI Number	:	1083875694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN LOUIS VICELJA D.D.S.

Provider Business Mailing Address
First Line	:	1711 VIA EL PRADO
Second Line	:	303
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5714
Country	:	US
Telephone Number	:	310-792-4833
Fax Number	:	310-792-4837

Provider Business Practice Location Address
First Line	:	1711 VIA EL PRADO
Second Line	:	303
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-5714
Country	:	US
Telephone Number	:	310-792-4833
Fax Number	:	310-792-4837

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

Provider Enumeration Date	:	06/17/2008
Last Update Date	:	06/17/2008

Similar Medicare Providers

1447358817 — DR. ROBERT A BARMORE D.D.S.
Practice Location Address:

1711 VIA EL PRADO , SUITE 400
REDONDO BEACH, CA
90277-5714

Practice Phone: 310-540-5444
Practice Fax:

1619078854 — DR. KARL ROBERT BINGEMANN D.D.S.
Practice Location Address:

1711 VIA EL PRADO , SUITE 400B
REDONDO BEACH, CA
90277-5714

Practice Phone: 310-792-8610
Practice Fax: 310-792-8620

1720148703 — ALEXANDER MEDICAL GROUP
Practice Location Address:

1711 VIA EL PRADO , SUITE 202
REDONDO BEACH, CA
90277-5714

Practice Phone: 310-316-1764
Practice Fax:

1265595136 — GEORGE E ALEXANDER M.D.
Practice Location Address:

1711 VIA EL PRADO , 202
REDONDO BEACH, CA
90277-5714

Practice Phone: 310-316-1764
Practice Fax: 310-316-1764

1881860120 — DR. RHODA S ROSS DDS
Practice Location Address:

1711 VIA EL PRADO , STE 303
REDONDO BEACH, CA
90277-5714

Practice Phone: 310-792-4833
Practice Fax:

1558686832 — GEORGE ERIC ALEXANDER A MEDICAL CORPORATION
Practice Location Address:

1711 VIA EL PRADO , SUITE 202
REDONDO BEACH, CA
90277-5714

Practice Phone: 310-316-1764
Practice Fax: 310-698-5777

Directions to “ MR. JOHN LOUIS VICELJA D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.