Basic Information
| Provider Information | |||||||||
| NPI: | 1750592093 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | E. CARMEL PRADEL, D.M.D, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9201 W SUNSET BLVD | ||||||||
| Address2: | SUITE #708 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900693701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102768317 | ||||||||
| FaxNumber: | 3102764186 | ||||||||
| Practice Location | |||||||||
| Address1: | 9201 W SUNSET BLVD | ||||||||
| Address2: | SUITE #708 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900693701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102768317 | ||||||||
| FaxNumber: | 3102764186 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2007 | ||||||||
| LastUpdateDate: | 04/16/2009 | ||||||||
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| AuthorizedOfficialLastName: | PRADEL | ||||||||
| AuthorizedOfficialFirstName: | E. | ||||||||
| AuthorizedOfficialMiddleName: | CARMEL | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3102768317 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223S0112X | DG033975 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Dental Providers | Dentist | Oral and Maxillofacial Surgery |
No ID Information.