Healthcare Provider Details

I. General information

NPI: 1366770471
Provider Name (Legal Business Name): PAOLA DUMAPLIN M.A/XT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2009
Last Update Date: 12/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1449 WARM SPRINGS DR
CHULA VISTA CA
91913-2891
US

IV. Provider business mailing address

1449 WARM SPRINGS DR
CHULA VISTA CA
91913-2891
US

V. Phone/Fax

Practice location:
  • Phone: 619-271-1375
  • Fax:
Mailing address:
  • Phone: 619-271-1375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number588918
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License NumberRHP 91072
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: