Provider Demographics
NPI:1275727851
Name:FERDINAND D. PATI, D.D.S., INC.
Entity type:Organization
Organization Name:FERDINAND D. PATI, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:D
Authorized Official - Last Name:PATI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-502-9925
Mailing Address - Street 1:918 E COLORADO ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1224
Mailing Address - Country:US
Mailing Address - Phone:818-502-9925
Mailing Address - Fax:818-502-1011
Practice Address - Street 1:918 E COLORADO ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1224
Practice Address - Country:US
Practice Address - Phone:818-502-9925
Practice Address - Fax:818-502-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-28
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47304122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB47304Medicaid