Provider Demographics
NPI:1790918423
Name:ELIAS, ELLIOTT, LAMPASI, FEHN, HARRIS & NGUYEN, ADC, INC
Entity Type:Organization
Organization Name:ELIAS, ELLIOTT, LAMPASI, FEHN, HARRIS & NGUYEN, ADC, INC
Other - Org Name:OASIS FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER PATIENT ACCOUNTING
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-241-7201
Mailing Address - Street 1:41278 MARGARITA ROAD
Mailing Address - Street 2:#101
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5579
Mailing Address - Country:US
Mailing Address - Phone:760-598-8644
Mailing Address - Fax:
Practice Address - Street 1:41278 MARGARITA RD
Practice Address - Street 2:#101
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5579
Practice Address - Country:US
Practice Address - Phone:951-695-2290
Practice Address - Fax:951-695-2291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty