Healthcare Provider Details

I. General information

NPI: 1093396434
Provider Name (Legal Business Name): DANA MARIE HUTCHISON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2021
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HEALTH SCIENCES RD
IRVINE CA
92617-3054
US

IV. Provider business mailing address

118 MED SURGE I
IRVINE CA
92697-4375
US

V. Phone/Fax

Practice location:
  • Phone: 949-824-6119
  • Fax:
Mailing address:
  • Phone: 949-824-5515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA190937
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: