Provider Demographics
NPI:1598898728
Name:RAMESH MULCHANDANI D.D.S
Entity Type:Organization
Organization Name:RAMESH MULCHANDANI D.D.S
Other - Org Name:R M MULCHANDANI DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:D.D.S
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:MULCHANDANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-676-3333
Mailing Address - Street 1:12223 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-3807
Mailing Address - Country:US
Mailing Address - Phone:310-676-3333
Mailing Address - Fax:
Practice Address - Street 1:12223 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-3807
Practice Address - Country:US
Practice Address - Phone:310-676-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAMESH MULCHANDANI DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-14
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACGP166337OtherCCS NUMBER
CAB29388-02OtherMEDI-CAL PROVIDER NUMBER
CA229388OtherDELTADENTAL ID NUMBER