Healthcare Provider Details

I. General information

NPI: 1386668473
Provider Name (Legal Business Name): THOMAS M. DAWES JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 S PALISADE DR STE 210
SANTA MARIA CA
93454-8906
US

IV. Provider business mailing address

116 S PALISADE DR STE 210
SANTA MARIA CA
93454-8906
US

V. Phone/Fax

Practice location:
  • Phone: 805-934-2488
  • Fax: 805-934-2480
Mailing address:
  • Phone: 805-934-2488
  • Fax: 805-934-2480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA69978
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: