Healthcare Provider Details

I. General information

NPI: 1780880815
Provider Name (Legal Business Name): RAYMOND DANN M.D. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 09/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 N DATE ST
ESCONDIDO CA
92025-3406
US

IV. Provider business mailing address

160 N DATE ST
ESCONDIDO CA
92025-3406
US

V. Phone/Fax

Practice location:
  • Phone: 760-746-2860
  • Fax: 760-738-7501
Mailing address:
  • Phone: 760-746-2860
  • Fax: 760-738-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC22179
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA34902
License Number StateCA

VIII. Authorized Official

Name: DR. RAYMOND DANN
Title or Position: OWNER
Credential: M.D.
Phone: 760-738-7926