Healthcare Provider Details

I. General information

NPI: 1104335934
Provider Name (Legal Business Name): DAWN MICHELLE VOLLMANN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2017
Last Update Date: 09/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 S BREA BLVD STE 100
BREA CA
92821-5377
US

IV. Provider business mailing address

1852 E ALMOND DR
ANAHEIM CA
92805-3423
US

V. Phone/Fax

Practice location:
  • Phone: 714-671-2936
  • Fax:
Mailing address:
  • Phone: 714-321-5049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number54950
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: