Provider Demographics
NPI:1992831408
Name:DIAZ, ARCELI PEREZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARCELI
Middle Name:PEREZ
Last Name:DIAZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ARCELI
Other - Middle Name:P
Other - Last Name:DIAZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS INC
Mailing Address - Street 1:823 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813
Mailing Address - Country:US
Mailing Address - Phone:562-432-1532
Mailing Address - Fax:562-432-6732
Practice Address - Street 1:823 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813
Practice Address - Country:US
Practice Address - Phone:562-432-1532
Practice Address - Fax:562-432-6732
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA426471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG9371001OtherMEDICAL