Provider Demographics
NPI:1992011324
Name:PASCUA, NOEMI (DDM)
Entity Type:Individual
Prefix:DR
First Name:NOEMI
Middle Name:
Last Name:PASCUA
Suffix:
Gender:F
Credentials:DDM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MESA AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-1912
Mailing Address - Country:US
Mailing Address - Phone:619-477-3770
Mailing Address - Fax:619-477-3701
Practice Address - Street 1:2016 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-5835
Practice Address - Country:US
Practice Address - Phone:619-477-3770
Practice Address - Fax:619-477-3701
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist