Provider Demographics
NPI:1295291391
Name:HUMMINGBIRD HEALTH ORGANIZATION
Entity type:Organization
Organization Name:HUMMINGBIRD HEALTH ORGANIZATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:TOLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-319-3851
Mailing Address - Street 1:326 N RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-5926
Mailing Address - Country:US
Mailing Address - Phone:909-875-1464
Mailing Address - Fax:
Practice Address - Street 1:23224 WESTWOOD ST
Practice Address - Street 2:
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5313
Practice Address - Country:US
Practice Address - Phone:909-319-3851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental