Healthcare Provider Details

I. General information

NPI: 1730026998
Provider Name (Legal Business Name): DOLOMITE MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1739 W AVENUE J
LANCASTER CA
93534-2703
US

IV. Provider business mailing address

1739 W AVENUE J
LANCASTER CA
93534-2703
US

V. Phone/Fax

Practice location:
  • Phone: 310-923-2723
  • Fax:
Mailing address:
  • Phone: 771-497-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: BABAK SHABATIAN
Title or Position: PHYSICIAN OWNER
Credential: M.D.
Phone: 310-923-2723