Provider Demographics
NPI:1134314495
Name:GFV GROUP INC
Entity Type:Organization
Organization Name:GFV GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:DAYOAN
Authorized Official - Last Name:VALDE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-913-4420
Mailing Address - Street 1:1415 1/2 N VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6023
Mailing Address - Country:US
Mailing Address - Phone:323-913-4420
Mailing Address - Fax:
Practice Address - Street 1:1415 1/2 N VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6023
Practice Address - Country:US
Practice Address - Phone:323-913-4420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA232651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB2326501OtherMEDICAL