| Jebcob | |
|
527 N Palm Ave Suite 106 Ontario CA 91762-3215 | |
| (909) 984-3618 | |
| (909) 984-9479 |
| Full Name | Jebcob |
|---|---|
| Speciality | Dentist |
| Location | 527 N Palm Ave, Ontario, California |
| Authorized Official Name and Position | Oscar Esparza (DENTIST) |
| Authorized Official Contact | 9099843618 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jebcob 527 N Palm Ave Ste 106 Ontario CA 91762-3215 Ph: (909) 984-3618 | Jebcob 527 N Palm Ave Suite 106 Ontario CA 91762-3215 Ph: (909) 984-3618 |
| NPI Number | 1255470803 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 07/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255470803 | NPI | - | NPPES |
| 10442-1 | Other | CA | BLUE SHIELD |
| D45252--01 | Medicaid | CA | |
| 828309 | Other | CA | UNITED CONCORDIA |
| B41648-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 41648 (California) | Primary |
| 122300000X | Dentist | 45252 (California) | Secondary |
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