Provider Demographics
NPI:1598733727
Name:MACHADO, LESTER (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:
Last Name:MACHADO
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 WASHINGTON ST
Mailing Address - Street 2:SUITE #710
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2231
Mailing Address - Country:US
Mailing Address - Phone:619-295-6774
Mailing Address - Fax:619-295-6776
Practice Address - Street 1:501 WASHINGTON ST
Practice Address - Street 2:SUITE #710
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2231
Practice Address - Country:US
Practice Address - Phone:619-295-6774
Practice Address - Fax:619-295-6776
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD290801223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G699841OtherCCS PROVIDER NUMBER
CA00G699843OtherCCS PROVER NUMBER
CAG92891-02OtherDENTI-CAL PROVIDER NUMBER
CAG92891-01OtherDENTI-CAL PROVIDER NUMBER