MEDICARE: DR. ALEJANDRO MAGAT D.M.D

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	42681	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	971512	OTHER	PA	UNITED CONCORDIA
2	520788	OTHER	CA	DENTICAL

General Provider Information

NPI Number	:	1215140413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEJANDRO MAGAT D.M.D

Provider Business Mailing Address
First Line	:	411 E HUNTINGTON DR STE 120
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-3788
Country	:	US
Telephone Number	:	626-821-1122
Fax Number	:	626-821-1133

Provider Business Practice Location Address
First Line	:	411 E HUNTINGTON DR STE 120
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-3788
Country	:	US
Telephone Number	:	626-821-1122
Fax Number	:	626-821-1133

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/08/2007

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