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NPI 1497702971

NPI 1497702971 : ISSA DAKKAK MD : CARMICHAEL, CA

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General NPI Number Information
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    NPI Number           |    1497702971
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    Entity Type          |    Individual 
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    Provider Name        |    ISSA DAKKAK MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/28/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    6660 COYLE AVE 
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    City                 |    CARMICHAEL
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    State                |    CA
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    Zip                  |    95608
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    Country              |    US
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    Telephone            |    916-966-6544
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5530 BIRDCAGE STREET STE #145
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    City                 |    CITRUS HEIGHTS
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    State                |    CA
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    Zip                  |    95610
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    Country              |    US
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    Telephone            |    209-956-7725
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    Fax                  |    209-956-7733
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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        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    A40784
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    License Number State |    CA
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