Provider Demographics
NPI:1629209382
Name:DANTE ALMENDRAL MD, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:DANTE ALMENDRAL MD, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANTE
Authorized Official - Middle Name:F
Authorized Official - Last Name:ALMENDRAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-690-1912
Mailing Address - Street 1:19749 CASTLEBAR DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748
Mailing Address - Country:US
Mailing Address - Phone:949-690-1912
Mailing Address - Fax:
Practice Address - Street 1:2425 NORTH BROADWAY ST.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031
Practice Address - Country:US
Practice Address - Phone:323-255-8085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G806680Medicaid
CA00G806680Medicaid