1700068426 NPI number — RICA CELINA GALVEZ ADORABLE DDS

Table of content: RICA CELINA GALVEZ ADORABLE DDS (NPI 1700068426)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700068426 NPI number — RICA CELINA GALVEZ ADORABLE DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADORABLE
Provider First Name:
RICA CELINA
Provider Middle Name:
GALVEZ
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GALVEZ
Provider Other First Name:
RICA CELINA
Provider Other Middle Name:
AGUILA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700068426
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6325 TOPANGA CANYON BLVD STE 307
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODLAND HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91367-2031
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-348-1494
Provider Business Mailing Address Fax Number:
818-592-0406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6325 TOPANGA CANYON BLVD STE 307
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODLAND HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91367-2031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-348-1494
Provider Business Practice Location Address Fax Number:
818-592-0406
Provider Enumeration Date:
12/04/2007

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: 122300000X , with the licence number:  56108 , 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)