Provider Demographics
NPI:1790827962
Name:BARRAMEDA, STEWART CLEDERA (DMD)
Entity Type:Individual
Prefix:MR
First Name:STEWART
Middle Name:CLEDERA
Last Name:BARRAMEDA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 E AMAR RD
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792
Mailing Address - Country:US
Mailing Address - Phone:626-964-6799
Mailing Address - Fax:626-964-8439
Practice Address - Street 1:1519 E AMAR RD
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792
Practice Address - Country:US
Practice Address - Phone:626-964-6799
Practice Address - Fax:626-964-8439
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice