Healthcare Provider Details

I. General information

NPI: 1902294762
Provider Name (Legal Business Name): DAWN M BARTOS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2015
Last Update Date: 01/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 SELKIRK DR
HUNTINGTON BEACH CA
92649-4830
US

IV. Provider business mailing address

5501 SELKIRK DR
HUNTINGTON BEACH CA
92649-4830
US

V. Phone/Fax

Practice location:
  • Phone: 714-377-5633
  • Fax:
Mailing address:
  • Phone: 714-377-5633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number426297
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: