Provider Demographics
NPI:1689898835
Name:ESLAO, LEONORA GUERRERO (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEONORA
Middle Name:GUERRERO
Last Name:ESLAO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4591 EL RANCHO VERDE DR
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623
Mailing Address - Country:US
Mailing Address - Phone:562-809-0926
Mailing Address - Fax:
Practice Address - Street 1:2901 WHITTIER BLVD
Practice Address - Street 2:STE D
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90023
Practice Address - Country:US
Practice Address - Phone:323-526-1992
Practice Address - Fax:323-526-1742
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42306122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB4230601OtherTREATING MEDI CAL PROVIDE