Provider Demographics
NPI:1609051390
Name:ALCALDE, OSCAR GERARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:GERARD
Last Name:ALCALDE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W LESLIE DR
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-2942
Mailing Address - Country:US
Mailing Address - Phone:626-676-6069
Mailing Address - Fax:
Practice Address - Street 1:5220 CLARK AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2618
Practice Address - Country:US
Practice Address - Phone:626-676-6069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice