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General NPI Number Information
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NPI Number | 1093006595
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Entity Type | Individual
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Provider Name | DANA CATHERINE DELELLIS MD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 1245 16TH ST STE 309
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City | SANTA MONICA
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State | CA
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Zip | 90404-1239
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Country | US
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Telephone | 858-220-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 1605 ARMACOST AVE APT 201
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City | LOS ANGELES
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State | CA
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Zip | 90025-3723
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Country | US
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Telephone | 858-220-4615
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 30996
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License Number State | OK
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