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NPI Code Detail

MEDICARE: DR. CHRISTOPHER MATTHEW PATUWO DDS

MEDICARE:  DR. CHRISTOPHER MATTHEW PATUWO  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
11223G0001XGeneral Practice Dentistry101927CA

General Provider Information

NPI Number : 1134648934
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTOPHER MATTHEW PATUWO DDS
Provider Business Mailing Address
First Line : 1300 FOX DR
Second Line :
City : FULLERTON
State : CA
Zip : 92835-3621
Country : US
Telephone Number : 714-782-8806
Fax Number :
Provider Business Practice Location Address
First Line : 6112 BEACH BLVD
Second Line :
City : BUENA PARK
State : CA
Zip : 90621-2306
Country : US
Telephone Number : 714-562-0402
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2017
Last Update Date : 04/05/2021

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Directions to “ DR. CHRISTOPHER MATTHEW PATUWO DDS” Practice Location

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