Provider Demographics
NPI:1306087465
Name:MALAGA FIGUEROA, EDMUNDO JOSE (DDS)
Entity type:Individual
Prefix:
First Name:EDMUNDO
Middle Name:JOSE
Last Name:MALAGA FIGUEROA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9620 SEPULVEDA BLVD
Mailing Address - Street 2:UNIT 58
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3364
Mailing Address - Country:US
Mailing Address - Phone:818-471-1910
Mailing Address - Fax:
Practice Address - Street 1:7922 ROSECRANS AVE.
Practice Address - Street 2:STE A
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-6043
Practice Address - Country:US
Practice Address - Phone:562-633-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-18
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA579021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice