Healthcare Provider Details

I. General information

NPI: 1205849858
Provider Name (Legal Business Name): ANTON ROBERT DOTSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 MISSION RANCH BLVD SUITE 110
CHICO CA
95926-2175
US

IV. Provider business mailing address

145 MISSION RANCH BLVD SUITE 110
CHICO CA
95926-2175
US

V. Phone/Fax

Practice location:
  • Phone: 530-896-2200
  • Fax: 530-896-2209
Mailing address:
  • Phone: 530-896-2200
  • Fax: 530-896-2209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number8888
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberG69131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: