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General NPI Number Information
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NPI Number | 1285691121
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Entity Type | Individual
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Provider Name | DIONISIO A. FERNANDES MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 10/25/2018
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Provider Practice Location Address
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Address Line | 13847 E 14TH ST. STE 112
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City | SAN LEANDRO
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State | CA
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Zip | 94578
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Country | US
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Telephone | 510-352-8585
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Fax | 510-352-8644
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Provider Business Mailing Address
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Address Line | 3448 MOWRY AVE
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City | FREMONT
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State | CA
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Zip | 94538-1422
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Country | US
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Telephone | 510-373-3000
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Fax | 510-744-9959
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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 | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | A29416
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License Number State | CA
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