Healthcare Provider Details

I. General information

NPI: 1427587013
Provider Name (Legal Business Name): NORA MATTEA MEHLMAN DUMONT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MAIN ST
BRAWLEY CA
92227-2630
US

IV. Provider business mailing address

215 DANBURY CIR N
ROCHESTER NY
14618-2748
US

V. Phone/Fax

Practice location:
  • Phone: 760-344-6471
  • Fax:
Mailing address:
  • Phone: 843-518-3958
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC201202
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number51141
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number306046-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: