Hermes Bustos Mallari | Redding, CA • PECOS Search

Hermes Bustos Mallari

Dentist

Dental Providers

2147 Court St, Redding, CA 96001-2531

(530) 246-4100 (530) 246-3381

PECOS Enrollment

Based on the most recent information from CMS, provider Hermes Bustos Mallari does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1033177407
Provider Type
Individual
Full Name
Mallari, Hermes Bustos
Title
Dr.

Credential
D.D.S.
Gender
Male
Enumeration Date
5/3/2006
Last Updated
7/8/2007

Contact Information

Practice Location

2147 Court St, Redding, CA 96001-2531

Unlisted Fax

Mailing Location

2246 Gold St, Redding, CA 96001-2419

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License 52427 California