Healthcare Provider Details
I. General information
NPI: 1093740680
Provider Name (Legal Business Name): VARONICA DIXON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/11/2006
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1690 BARTON RD STE 104
REDLANDS CA
92373-4230
US
IV. Provider business mailing address
PO BOX 35380
LAS VEGAS NV
89133-5380
US
V. Phone/Fax
- Phone: 909-793-2896
- Fax: 909-796-4158
- Phone: 702-579-3203
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | G68653 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: