MEDICARE: DR. DAVID M DOBOS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	G57276	CA
2	2084P0800X	Psychiatry Physician	G57276	CA

General Provider Information

NPI Number	:	1548318348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID M DOBOS MD

Provider Business Mailing Address
First Line	:	PO BOX 7549
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92513-7549
Country	:	US
Telephone Number	:	951-358-4501
Fax Number	:	951-358-4513

Provider Business Practice Location Address
First Line	:	31764 CASINO DR STE 300
Second Line	:
City	:	LAKE ELSINORE
State	:	CA
Zip	:	92530-2312
Country	:	US
Telephone Number	:	951-471-4645
Fax Number	:	951-471-4687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	06/11/2021

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