Provider Demographics
NPI:1558427252
Name:POSTGATE, JOHN (EIN-)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:POSTGATE
Suffix:
Gender:M
Credentials:EIN-
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-2333
Mailing Address - Country:US
Mailing Address - Phone:661-725-9587
Mailing Address - Fax:661-725-6609
Practice Address - Street 1:1107 11TH AVE
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2333
Practice Address - Country:US
Practice Address - Phone:661-725-9587
Practice Address - Fax:661-725-6609
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist