Soedharsono Judo is a Dentist in Pomona, California. Soedharsono Judo practices all healthcare services and medical treatments related to Dentist. The NPI Number for Soedharsono Judo is 1093873218. The last update date is 2007-07-08.
Soedharsono Judo's current location address is 1087 North Park Avenue, Pomona, California. You can contact this provider via phone number 9096290201. The mailing address for Soedharsono Judo is 1087 North Park Avenue, Pomona, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Soedharsono Judo |
|---|---|
| Address | 1087 North Park Avenue, Pomona, California |
| Phone Number | 9096290201 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1093873218 |
|---|---|
| Provider Enumeration Date | 2006-12-04 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1087 North Park Avenue |
|---|---|
| City | Pomona |
| State | California (CA) |
| Post Code | 917683026 |
| Phone Number | 9096290201 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 34127 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| G9044501 | CA | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Soedharsono Judo by the Centers for Medicare & Medicaid Services?
The Soedharsono Judo has been issued the NPI (National Provider Identifier) 1093873218. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Soedharsono Judo's physical address?
The Soedharsono Judo is physically located at 1087 North Park Avenue, in the city of Pomona, CA, with the postal code 917683026.
What is the area of specialization for Soedharsono Judo, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Soedharsono Judo is Dentist, and the corresponding taxonomy code that categorizes this area of expertise is 122300000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1093873218 to Soedharsono Judo?
The Centers for Medicare & Medicaid Services originally issued the 1093873218 to Soedharsono Judo on 2006-12-04.
When was the information related to Soedharsono Judo most recently updated or refreshed?
The details pertaining to the Soedharsono Judo, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.
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