Healthcare Provider Details
I. General information
NPI: 1275995862
Provider Name (Legal Business Name): ARIANA MURRAY DAGDAG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/23/2016
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
751 S BASCOM AVE
SAN JOSE CA
95128-2604
US
IV. Provider business mailing address
751 S BASCOM AVE
SAN JOSE CA
95128-2604
US
V. Phone/Fax
- Phone: 408-885-5554
- Fax:
- Phone: 408-885-5554
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | A151998 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: