Provider Demographics
NPI:1649325820
Name:NONATO H. ELAZEGUI.DMD.INC
Entity type:Organization
Organization Name:NONATO H. ELAZEGUI.DMD.INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NONATO
Authorized Official - Middle Name:H
Authorized Official - Last Name:ELAZEGUI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:626-350-3295
Mailing Address - Street 1:4565 N PECK ROAD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732
Mailing Address - Country:US
Mailing Address - Phone:626-350-3295
Mailing Address - Fax:626-350-3371
Practice Address - Street 1:4565 N PECK ROAD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732
Practice Address - Country:US
Practice Address - Phone:626-350-3295
Practice Address - Fax:626-350-3371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental