Provider Demographics
NPI:1538379078
Name:LOUIE, CAYLEY SHERMAN (DDS)
Entity type:Individual
Prefix:DR
First Name:CAYLEY
Middle Name:SHERMAN
Last Name:LOUIE
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 1:21320 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5606
Mailing Address - Country:US
Mailing Address - Phone:310-792-1237
Mailing Address - Fax:310-792-1245
Practice Address - Street 1:21320 HAWTHORNE BLVD
Practice Address - Street 2:SUITE #201
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5606
Practice Address - Country:US
Practice Address - Phone:310-792-1237
Practice Address - Fax:310-792-1245
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45142122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA263253730OtherBLUE CROSS