Healthcare Provider Details

I. General information

NPI: 1104088830
Provider Name (Legal Business Name): TERRIS R DUNN MD A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 TELEGRAPH AVE
BERKELEY CA
94705-1119
US

IV. Provider business mailing address

2828 TELEGRAPH AVE
BERKELEY CA
94705-1119
US

V. Phone/Fax

Practice location:
  • Phone: 510-848-8404
  • Fax:
Mailing address:
  • Phone: 510-848-8404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRI R DUNN
Title or Position: M.D.
Credential:
Phone: 510-848-8404