1508849241 NPI number — MS. ALMA CARBONELL ROBLES DMD

Table of content: MS. ALMA CARBONELL ROBLES DMD (NPI 1508849241)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508849241 NPI number — MS. ALMA CARBONELL ROBLES DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBLES
Provider First Name:
ALMA
Provider Middle Name:
CARBONELL
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508849241
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4751 WILSHIRE BLVD STE 203C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90010-3860
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
213-383-5047
Provider Business Mailing Address Fax Number:
233-847-5051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3875 WILSHIRE BLVD
Provider Second Line Business Practice Location Address:
SUITE 1301
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90010-3205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-383-5047
Provider Business Practice Location Address Fax Number:
213-383-3947
Provider Enumeration Date:
11/28/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  B36603 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 36603 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)