Healthcare Provider Details

I. General information

NPI: 1851461768
Provider Name (Legal Business Name): CHARITA DAGCUTA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 ALHAMBRA AVE CONTRA COSTA REGIONAL MEDICAL CENTER AND HEALTH CENTERS
MARTINEZ CA
94553-3156
US

IV. Provider business mailing address

50 DOUGLAS DRIVE SUITE 391 HEALTH SERVICES ADMINISTRATION
MARTINEZ CA
94553-4098
US

V. Phone/Fax

Practice location:
  • Phone: 925-370-5110
  • Fax: 925-370-5142
Mailing address:
  • Phone: 925-957-5429
  • Fax: 925-957-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA35501
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: