Provider Demographics
NPI:1417485004
Name:MARVIN S KOBORI DDS A PC
Entity Type:Organization
Organization Name:MARVIN S KOBORI DDS A PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:SADAO
Authorized Official - Last Name:KOBORI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-359-1463
Mailing Address - Street 1:1031 TERRA NOVA BLVD
Mailing Address - Street 2:
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-4308
Mailing Address - Country:US
Mailing Address - Phone:650-359-1463
Mailing Address - Fax:650-359-4489
Practice Address - Street 1:1031 TERRA NOVA BLVD
Practice Address - Street 2:
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-4308
Practice Address - Country:US
Practice Address - Phone:650-359-1463
Practice Address - Fax:650-359-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty