Healthcare Provider Details

I. General information

NPI: 1891875860
Provider Name (Legal Business Name): DAWN ELDERS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 S HICKORY ST SUITE 126
ESCONDIDO CA
92025-4359
US

IV. Provider business mailing address

1750 MACERO STREET
ESCONDIDO CA
92029
US

V. Phone/Fax

Practice location:
  • Phone: 760-747-8935
  • Fax: 760-747-7951
Mailing address:
  • Phone: 760-747-8935
  • Fax: 760-747-7951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberNP14129
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: