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General NPI Number Information
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NPI Number | 1639170806
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Entity Type | Individual
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Provider Name | ABDULLAH M AL DWAIRI M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 07/01/2011
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Provider Practice Location Address
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Address Line | 680 COHASSET RD
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City | CHICO
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State | CA
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Zip | 95926-2213
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Country | US
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Telephone | 530-342-4395
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Fax | 530-894-2325
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Provider Business Mailing Address
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Address Line | PO BOX A D
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City | YUBA CITY
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State | CA
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Zip | 95992-1396
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Country | US
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Telephone | 530-751-3769
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Fax | 530-751-1237
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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 | A79949
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | A79949
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License Number State | CA
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