Moncada, Marcelo Geneston

Moncada, Marcelo Geneston is an individual health care provider with primary practice located at 1321 N Vermont Ave Ste. B, Los Angeles CA 90027-6307. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Moncada, Marcelo Geneston can be contacted via phone (323) 663-7897.

Contact Information

Primary practice address
1321 N Vermont Ave Ste. B Los Angeles CA 90027-6307
Fax: (323) 663-7803
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 43643 California

Profile Details

NPI number 1215935564
LBN Legal business name Moncada, Marcelo Geneston
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Jul 8th, 2007 - about 17 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 1215935564 NPPES
California Other B43643-01 MEDI-CAL

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