Healthcare Provider Details

I. General information

NPI: 1649492745
Provider Name (Legal Business Name): MICHAEL C DUGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868-3201
US

IV. Provider business mailing address

5300 MCCONNELL AVE
LOS ANGELES CA
90066-7026
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-8888
  • Fax:
Mailing address:
  • Phone: 310-482-5336
  • Fax: 310-482-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberG71782
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: