Medina, Eduardo

Medina, Eduardo is an individual health care provider with primary practice located at 8454 Victoria Ave Apt C , South Gate CA 90280-2364. He recently has only one registered license in Dental Providers / Dental Assistant, which is considered as his primary health care specialty. Medina, Eduardo can be contacted via phone (818) 445-1201.

Contact Information

Primary practice address
8454 Victoria Ave Apt C South Gate CA 90280-2364
Phone: (818) 445-1201
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Assistant 126800000X 92794 California

Profile Details

NPI number 1629652854
LBN Legal business name Medina, Eduardo
Credentials Registered Dental Assistant (RDA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2021
Last updated May 12th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629652854 NPPES
California MEDICAID 92794

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