Healthcare Provider Details

I. General information

NPI: 1235201054
Provider Name (Legal Business Name): DAWN M. BELARDINELLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN MARIE PORTEOUS MD

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 01/10/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 HICKEY BLVD
DALY CITY CA
94015-2770
US

IV. Provider business mailing address

1800 HARRISON ST FL 7
OAKLAND CA
94612-3466
US

V. Phone/Fax

Practice location:
  • Phone: 650-742-2000
  • Fax:
Mailing address:
  • Phone: 510-625-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG74918
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: