| Peninsula Oral Surgery & Implants | |
|
3445 Pacific Coast Hwy Suite 205 Torrance CA 90505 | |
| (310) 325-7800 | |
| (310) 325-7804 |
| Full Name | Peninsula Oral Surgery & Implants |
|---|---|
| Speciality | Oral & Maxillofacial Surgery |
| Location | 3445 Pacific Coast Hwy, Torrance, California |
| Authorized Official Name and Position | Thomas T. Omoto (PRESIDENT) |
| Authorized Official Contact | 3103257800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peninsula Oral Surgery & Implants 3445 Pacific Coast Hwy Suite 205 Torrance CA 90505 Ph: (310) 325-7800 | Peninsula Oral Surgery & Implants 3445 Pacific Coast Hwy Suite 205 Torrance CA 90505 Ph: (310) 325-7800 |
| NPI Number | 1255357893 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 10/27/2022 |
| Certification Date | 10/27/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255357893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 31506 (California) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | (NU) | Primary |
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