Healthcare Provider Details

I. General information

NPI: 1427092741
Provider Name (Legal Business Name): DONALD M DAWES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 E HICKORY AVE
LOMPOC CA
93436-7337
US

IV. Provider business mailing address

301 LOYOLA DR
SANTA BARBARA CA
93109-2013
US

V. Phone/Fax

Practice location:
  • Phone: 805-737-3333
  • Fax:
Mailing address:
  • Phone: 805-452-4574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01082476A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA73388
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: