Healthcare Provider Details

I. General information

NPI: 1518947431
Provider Name (Legal Business Name): DEAN ALAN BAILEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3235 ALBACORE ALY NEPMU-5 OIC
SAN DIEGO CA
92136-5199
US

IV. Provider business mailing address

238 A AVE
CORONADO CA
92118-1913
US

V. Phone/Fax

Practice location:
  • Phone: 619-556-7070
  • Fax:
Mailing address:
  • Phone: 619-398-5495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberG056673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: