Provider Demographics
NPI:1457804734
Name:RAMSEY A. EZAKI, D.D.S., INC.
Entity Type:Organization
Organization Name:RAMSEY A. EZAKI, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMSEY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:EZAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-947-9958
Mailing Address - Street 1:16336 WHITTIER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2900
Mailing Address - Country:US
Mailing Address - Phone:562-947-9958
Mailing Address - Fax:562-943-6751
Practice Address - Street 1:16336 WHITTIER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2900
Practice Address - Country:US
Practice Address - Phone:562-947-9958
Practice Address - Fax:562-943-6751
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAMSEY A. EZAKI, D.D.S., INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA137894OtherUNITED CONCORDIA