Healthcare Provider Details

I. General information

NPI: 1376629899
Provider Name (Legal Business Name): DANA C. WON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 DISTEL CIR
LOS ALTOS CA
94022-1404
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 408-523-3960
  • Fax:
Mailing address:
  • Phone: 408-523-3625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA74339
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberA74339
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: