Pribadi, Darmawan
Pribadi, Darmawan is an individual health care provider with primary practice located at 1051 South Garey Avenue , Pomona CA 91766. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Pribadi, Darmawan can be contacted via phone (909) 620-0600.Contact Information
Primary practice address
1051 South Garey Avenue
Pomona CA 91766
Phone: (909) 620-0600
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 33651 | California |
Profile Details
| NPI number | 1508908534 |
|---|---|
| LBN Legal business name | Pribadi, Darmawan |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508908534 | NPPES |
| California | MEDICAID | B 33651 01 |
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