MEDICARE: MR. DAVID MICHAEL DORIGUZZI PA-C

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	363AM0700X	Medical Physician Assistant	PA16586	CA

General Provider Information

NPI Number	:	1730195728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID MICHAEL DORIGUZZI PA-C

Provider Business Mailing Address
First Line	:	44725 10TH ST W
Second Line	:	STE 170
City	:	LANCASTER
State	:	CA
Zip	:	93534-3000
Country	:	US
Telephone Number	:	661-948-6011
Fax Number	:	661-723-7999

Provider Business Practice Location Address
First Line	:	44725 10TH ST W
Second Line	:	STE 210
City	:	LANCASTER
State	:	CA
Zip	:	93534-3033
Country	:	US
Telephone Number	:	661-948-6011
Fax Number	:	661-949-8686

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	01/25/2017

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Directions to “ MR. DAVID MICHAEL DORIGUZZI PA-C” Practice Location

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