Healthcare Provider Details

I. General information

NPI: 1750299376
Provider Name (Legal Business Name): MR. DAVID WAYNE DIXON JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6434 YUCCA ST 308 LOS ANGELES
LOS ANGELES CA
90028
US

IV. Provider business mailing address

6434 YUCCA ST 308
LOS ANGELES CA
90028
US

V. Phone/Fax

Practice location:
  • Phone: 404-519-2035
  • Fax:
Mailing address:
  • Phone: 404-519-2035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: